HESI A2 Entrance Exam: What It Is and Where to Start

The HESI A2 entrance exam is one of the most common tests nursing schools use to assess whether an applicant is ready for the program. Many candidates register for it without a clear picture of what it actually measures, or how to prepare.

This guide explains what the exam is, how it differs from the HESI Exit Exam, and exactly where to begin your preparation based on your own situation.

What is the HESI A2?

The HESI A2's full name is the Health Education Systems Incorporated Admission Assessment. It is an entrance exam used by many nursing and allied health programs to evaluate whether applicants have the academic foundation to handle a demanding healthcare curriculum.

Unlike general college entrance exams such as the SAT or ACT, the HESI A2 is built specifically for healthcare education. It focuses on skills you will use directly in nursing coursework: interpreting written material, performing dosage-related math, and understanding basic anatomy. It is developed by Elsevier and administered on campus, at testing centers, or through proctored online sessions via Evolve.

The exam is modular, which means there is no single fixed format every student takes. Your school chooses which sections to test from the eight available. Our guide to what the HESI A2 exam covers breaks down each section.

HESI A2 vs HESI Exit: which one are you facing?

If you are applying to nursing school, you need the A2. The Exit Exam comes years later, near the end of your program. "HESI" is not one test but a family of exams from the same publisher, and the A2 and the Exit Exam (sometimes labeled E2) serve completely different purposes at completely different points in your training.

The HESI A2 is not the only entrance exam nursing schools use. Some programs use the ATI TEAS instead, and a handful accept either. If you are not yet sure which your school requires, our comparison of TEAS vs HESI covers how the two differ, and our guide to whether the ATI TEAS is difficult is useful if the TEAS turns out to be your exam. For the wider admissions picture, see our nursing school requirements guide.

Route by your situation

Every applicant starts from a different place. Some are fresh out of high school; others are switching careers after a decade in another field. Some have already registered; others are still choosing programs. Find the row below that matches where you are right now, then follow the starting point and guide beside it.

Start with what your program requires

This is the step most applicants skip, and it costs them time, money, and avoidable stress. Before you open a textbook, get these six answers from your nursing program's admissions office or website. Studying the wrong sections is the single most common early mistake, and it is entirely preventable.

• Which sections are required? Confirm whether you need Biology, Chemistry, Anatomy & Physiology, or Physics on top of the core four.

• What is the minimum score? Look for both composite and individual section cutoffs.

• How many attempts are allowed? Some programs permit unlimited retakes. Others cap you at two or three per year with a mandatory waiting period.

• What is the score validity period? HESI A2 scores are typically valid for one to two years, but policies vary.

• Where will you test? Options include commercial testing centers, your school's campus lab, or remote proctored sessions. Some programs only accept in-person scores.

• What does it cost? Fees vary by institution. Our guide to HESI exam cost explains why the price differs from school to school.

Once you have those answers, build a study schedule that gives the most time to your weakest required sections. If Anatomy & Physiology is on your list and you have not taken the course recently, give it the largest block — it is consistently among the hardest sections for applicants. Prioritize the cardiovascular, respiratory, renal, endocrine, and nervous systems.

Frequently Asked Questions

Is the HESI A2 hard?

It is rigorous but predictable. The same content areas and question styles recur across versions, which makes it unusually responsive to focused study — unlike exams that test open-ended judgment.

What score do I need to pass?

It depends entirely on your program. Many set a 75% minimum per section, and competitive programs sometimes ask for 80% or higher. Confirm the number with your school rather than assuming a national standard, because there isn't one.

How long should I study?

Most applicants do well with four to eight weeks of focused preparation, adjusted for how many sections they are taking and how recent their science coursework is.

Can I retake the HESI A2 if I don't pass?

Usually yes. Most schools impose a waiting period and cap attempts per year, but the specifics differ by institution — check your program's policy directly rather than relying on a general rule.

Is the HESI A2 the same as the HESI Exit exam?

No. The A2 is an entrance exam taken before admission. The Exit Exam comes near the end of a nursing program and predicts NCLEX readiness. They test different content for different purposes.

The bottom line

The HESI A2 exists to check whether you are academically ready for nursing coursework, and it uses a modular format drawing on up to eight subject areas depending on your school.

The biggest early mistake applicants make isn't poor studying — it's studying the wrong sections, because they never confirmed what their program actually requires. Get that answer first. Then work out where you sit on the calendar, whether that is two months out or two weeks, and choose your study path accordingly.

And if a school mentions an "Exit exam" instead, that is a different test entirely, aimed at students finishing a program rather than starting one. Once you know which exam you are facing and what it covers, the HESI A2 stops being intimidating and starts being manageable.