- The Seven Content Areas: An Overview
- Domain 1: Mathematics
- Domain 2: Reading Comprehension
- Domain 3: Vocabulary and General Knowledge
- Domain 4: Grammar
- Domain 5: Biology
- Domain 6: Chemistry
- Domain 7: Anatomy and Physiology
- How Schools Select Sections (And Why It Varies)
- Scheduling Domains by Week
- Frequently Asked Questions
- The HESI A2 covers seven academic content areas: Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, and Anatomy...
- Elsevier's HESI NG platform administers the exam; each nursing or allied health program chooses which sections you must take.
- Programs - not Elsevier - set the required sections, admission benchmark, retake rules, and how scores are used.
- The current official prep reference is the Admission Assessment Exam Review, 6th Edition, published in 2024.
The Seven Content Areas: An Overview
The HESI Admission Assessment (A2) Exam is built from seven core academic sections, and understanding what each one actually tests is the fastest way to stop guessing and start preparing with intent. Elsevier, through its HESI NG platform, publishes and administers the exam, but individual nursing and allied health programs decide which of the seven sections you'll actually sit for. Some schools require the full slate; others test only three or four areas relevant to their curriculum.
Because the content mix is program-dependent, the single most important thing you can do before opening a study guide is confirm exactly which sections your target school requires. This article breaks down all seven domains in the order most candidates encounter them, and pairs each one with the kind of preparation that actually moves the needle. For a broader walkthrough of how to structure your entire prep timeline, see the HESI A2 Study Guide 2026: How to Pass on Your First Attempt.
Domain 1: Mathematics
Mathematics
This section evaluates the arithmetic and applied math skills nursing programs consider foundational for safe clinical practice, particularly around dosage calculations and measurement conversions.
- Whole number, fraction, and decimal operations
- Ratio, proportion, and percentage problems
- Metric conversions and basic unit analysis
- Reading and interpreting numeric data presented in simple word-problem form
Because many programs allow limited or no calculator access on this section - a setting each school configures independently - candidates should practice mental math and long-hand calculation rather than assuming a calculator will always be available. Confirm your program's calculator policy early; it changes how you should drill this domain.
Domain 2: Reading Comprehension
Reading Comprehension
This section measures how well you extract meaning, sequence, and inference from passages similar in style to what you'll encounter in nursing textbooks and clinical documentation.
- Identifying main idea versus supporting detail
- Drawing logical inferences from passage context
- Understanding author purpose and tone
- Following multi-step written instructions accurately
Because this section is timed at whatever interval your program configures, pacing is as important as comprehension. Practicing with passages under a clock - rather than reading untimed - builds the specific stamina this domain rewards.
Domain 3: Vocabulary and General Knowledge
Vocabulary and General Knowledge
This domain tests recognition and application of terminology commonly encountered in healthcare settings, along with general academic vocabulary.
- Medical and clinical root words, prefixes, and suffixes
- Context-based word meaning questions
- Commonly confused terms in healthcare communication
Because this section leans heavily on memorization rather than reasoning, it responds well to steady daily review rather than last-minute cramming. Flashcard-based repetition of prefixes like "hyper-," "brady-," and "-itis" pays off disproportionately here.
Domain 4: Grammar
Grammar
This section checks command of standard written English mechanics - the kind of clear, accurate communication expected in charting, patient education materials, and academic writing.
- Subject-verb agreement and sentence structure
- Correct usage of commonly misapplied word pairs
- Punctuation and capitalization rules
- Identifying grammatically correct versus incorrect sentences
Grammar questions tend to be short and rule-based, which makes this domain one of the more efficient ones to review in short daily bursts rather than long study blocks.
Domain 5: Biology
Biology
This section covers general biological concepts that underpin coursework in physiology, microbiology, and pathophysiology later in a nursing or allied health program.
- Cell structure and basic cellular processes
- Genetics and inheritance fundamentals
- Classification of organisms and basic ecology
- Core biochemical concepts relevant to living systems
Candidates coming from a non-science background often underestimate this domain. Building a simple glossary of cell components and processes before moving into anatomy-heavy content pays dividends across multiple sections.
Domain 6: Chemistry
Chemistry
This section addresses foundational chemistry concepts relevant to understanding medications, lab values, and bodily chemical processes.
- Atomic structure and the periodic table
- Chemical bonding and basic reactions
- Acids, bases, and pH concepts
- Solutions, concentrations, and basic measurement units
Chemistry and Mathematics questions frequently overlap in style - both reward comfort with units and proportional reasoning - so reviewing them in adjacent study sessions can reinforce both domains simultaneously.
Domain 7: Anatomy and Physiology
Anatomy and Physiology
Often considered the most content-dense of the seven sections, this domain tests knowledge of body systems, structures, and their functions.
- Skeletal, muscular, and integumentary systems
- Cardiovascular, respiratory, and nervous systems
- Digestive, endocrine, and urinary systems
- How organ systems interact to maintain homeostasis
Because this section draws on the widest breadth of material, most candidates need more calendar time for it than for any other domain. Organize review by system rather than trying to memorize isolated facts, and revisit the Biology domain's cellular concepts as a foundation.
Key Takeaway
Treat Anatomy and Physiology as your anchor domain: block out the largest share of your study calendar for it, and use Biology review as a warm-up since the two domains reinforce each other.
How Schools Select Sections (And Why It Varies)
Elsevier's HESI NG platform gives programs significant configuration control. Beyond choosing which of the seven academic sections above apply, schools may also add a Learning Style assessment, a Personality Style assessment, or a version that includes Critical Thinking. Each institution independently sets the testing window, section timer, calculator access, payment process, score reporting method, and whether proctoring happens onsite or remotely through the Elsevier Secure Browser.
This is why comparing notes with someone who tested at a different school can be misleading - their exam may have looked nothing like yours. Before you build a study plan, check your target program's admissions page or advising office for the exact section list, and review our HESI A2 Requirements 2026: Eligibility, Prerequisites & How to Qualify guide for the broader eligibility picture.
| Configuration Element | Set By |
|---|---|
| Which of the 7 sections are required | Individual school/program |
| Admission benchmark or minimum score | Individual school/program |
| Retake rules and waiting periods | Individual school/program |
| Testing window and section timer | Individual school/program (via HESI NG) |
| Calculator access | Individual school/program |
| Proctoring method (onsite/remote via Elsevier Secure Browser) | Individual school/program |
| Exam publication and administration | Elsevier / HESI NG |
Because so much varies by institution, it's worth reading how the overall exam difficulty and scoring expectations are typically framed before you commit to a study schedule. Our How Hard Is the HESI A2 Exam? Complete Difficulty Guide 2026 article and HESI A2 Passing Score 2026: Exactly What You Need to Pass breakdown both explain what "passing" typically means once your program sets its own benchmark.
Scheduling Domains by Week
Once you know which sections your program requires, sequence your review so that content-heavy domains get more runway and memorization-heavy domains get shorter, repeated exposure. A four-week structure built around the seven domains might look like this:
Foundations: Mathematics & Grammar
- Drill fraction, decimal, ratio, and conversion problems daily
- Review sentence structure and commonly confused word pairs
- Confirm your program's calculator policy for the math section
Comprehension & Vocabulary
- Practice timed reading passages to build pacing habits
- Build a running list of medical prefixes, roots, and suffixes
- Start light review of Biology terminology to prep for Week 3
Science Core: Biology & Chemistry
- Work through cell structure, genetics, and classification topics
- Review periodic table basics, bonding, and pH concepts
- Connect chemistry unit conversions back to Mathematics practice
Deep Dive: Anatomy and Physiology + Full Review
- Work system-by-system: skeletal, cardiovascular, respiratory, nervous, and more
- Take full-length timed practice sessions across all required domains
- Revisit weak areas identified in Weeks 1-3
This structure isn't a rigid template - adjust it based on which sections your school actually requires and where your own diagnostic results show weakness. For a condensed, one-page reference to keep nearby during final review, see the HESI A2 Cheat Sheet 2026: One-Page Review of Must-Know Facts.
Why Domain Mastery Matters Beyond Test Day
The HESI A2 is an admissions assessment rather than a renewable certification, which means its purpose is narrower than some candidates assume: it exists to help programs gauge readiness across foundational academic areas before you begin coursework, not to certify you for practice. That said, the seven domains aren't arbitrary - Mathematics and Chemistry connect directly to dosage calculation coursework, Biology and Anatomy and Physiology form the backbone of first-year science classes, and Reading Comprehension, Vocabulary and General Knowledge, and Grammar all reflect the communication skills programs expect from day one.
If you're still weighing whether investing serious prep time into this exam makes sense for your situation, our Is the HESI A2 Certification Worth It? Complete ROI Analysis 2026 article walks through that decision in more detail. And if you want a refresher on the exam's origin and purpose before diving into domain-specific study, start with What Is HESI A2?.
Key Takeaway
Don't study the seven domains in isolation - Mathematics reinforces Chemistry, and Biology reinforces Anatomy and Physiology. Pairing related domains in the same study week strengthens retention across both.
Turning Domain Knowledge Into Exam-Day Performance
Knowing what each domain covers is only half the battle - the other half is practicing under conditions that resemble the actual test. Since testing can occur onsite or remotely through the Elsevier Secure Browser depending on how your program configures it, it's worth simulating whichever environment you'll actually face. If you'll test remotely, practice in a quiet, distraction-free space with the same time limits your program has set.
Running full-length, timed practice sessions across all seven domains - not just the ones you find easiest - is the most reliable way to surface weak spots before test day. You can build that habit directly on our practice test platform, where domain-specific question sets mirror the structure described above. Working through realistic practice questions repeatedly, rather than passively rereading notes, is consistently the difference-maker candidates report.
Frequently Asked Questions
No. Each school selects which of the seven academic sections - Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, and Anatomy and Physiology - it requires. Some programs also add a Learning Style, Personality Style, or Critical Thinking component.
There's no universal order, but many candidates start with Mathematics and Grammar since these rely on rule-based skills that improve quickly with daily practice, then move into the more content-heavy Biology and Anatomy and Physiology domains.
Calculator access is configured by each individual program, so it can vary. Confirm your school's policy directly before assuming you will or won't have one available.
Elsevier's current guidance supports both onsite and remote proctoring through the Elsevier Secure Browser, but whether remote testing is offered depends on your program's setup.
The current official preparation reference is the Admission Assessment Exam Review, 6th Edition, published in 2024. Pairing it with timed practice questions covering each domain is the most direct way to prepare.