- The HESI A2 covers up to seven sections: Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, and Anatomy and...
- Elsevier, through HESI NG, publishes and administers the exam; individual schools choose which sections you take.
- Every program sets its own passing benchmark, retake policy, and score-use rules - there is no single universal cutoff.
- The current official prep reference is Admission Assessment Exam Review, 6th Edition (2024).
What the HESI A2 Actually Tests
The HESI Admission Assessment (A2) Exam is not a licensing exam and it is not a professional certification you renew every few years. It is an admissions screening tool that nursing and allied health programs use to gauge whether an applicant has the academic foundation to handle the coursework ahead. Elsevier publishes and administers the exam through its HESI NG platform, but the school you're applying to - not Elsevier - decides which sections you'll sit for, what score counts as passing, and how the results factor into your admission decision.
That distinction matters enormously for how you prepare. Because the HESI A2 draws from up to seven possible academic sections, plus optional Learning Style, Personality Style, or Critical Thinking add-ons some programs choose to include, no two candidates necessarily face the identical exam. Before you open a single practice question, your first move should be confirming exactly which sections your target program requires. For a full walkthrough of eligibility questions and program-specific prerequisites, see our HESI A2 Requirements guide.
Breaking Down All Seven Content Areas
The seven academic sections that make up the HESI A2 question bank are Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, and Anatomy and Physiology. Most nursing programs require a subset rather than all seven, so treat the list below as a menu you cross-check against your program's requirements - not a fixed syllabus. We cover each area in far more depth, including sample question types and study resources, in our HESI A2 Exam Domains guide.
Domain 1: Mathematics
Covers the arithmetic, fractions, ratios, conversions, and basic algebra a nursing student needs for dosage calculations and lab interpretation.
- Metric and household conversions
- Ratio-proportion and dimensional analysis problems
- Percentages, decimals, and basic equation solving
Domain 2: Reading Comprehension
Tests your ability to extract main ideas, inferences, and supporting details from short passages under time pressure.
- Identifying stated vs. implied information
- Author's purpose and tone
- Summarizing and sequencing steps in a passage
Domain 3: Vocabulary and General Knowledge
Assesses word recognition, including many terms with clinical or medical roots that recur throughout nursing coursework.
- Medical prefixes, suffixes, and root words
- Context-based word meaning
- Commonly confused general-vocabulary terms
Domain 4: Grammar
Checks command of standard written English mechanics, which matters for clinical documentation and patient communication.
- Subject-verb agreement and pronoun usage
- Correct word choice and sentence structure
- Punctuation and capitalization conventions
Domain 5: Biology
Covers foundational cell and organism-level biology that underlies physiology coursework.
- Cell structure, function, and division
- Basic genetics and metabolism concepts
- Ecology and organism-level biological processes
Domain 6: Chemistry
Tests general chemistry principles relevant to pharmacology and lab science courses later in a nursing curriculum.
- Atomic structure and the periodic table
- Chemical bonding and reactions
- Solutions, pH, and basic stoichiometry
Domain 7: Anatomy and Physiology
Often the most heavily emphasized science section, covering body systems in depth.
- Skeletal, muscular, and integumentary systems
- Cardiovascular, respiratory, and nervous systems
- Homeostasis and organ-system interrelationships
Key Takeaway
Don't study all seven sections evenly if your program only requires a subset. Get your school's exact list in writing, then weight your remaining study time toward the sections you'll actually be tested on.
How the Exam Is Registered, Timed, and Proctored
Because Elsevier licenses the HESI A2 platform to individual schools, the logistics of registering and sitting for the exam vary by program. Each school configures its own testing window, section timer, calculator access, payment process, score reporting, and proctoring format. Current Elsevier guidance supports both onsite testing and remote proctoring through the Elsevier Secure Browser, so it's worth confirming early which format your program uses - the setup, ID verification, and environment rules differ between the two.
Because fees, deadlines, and retake windows are set at the program level rather than by a single universal schedule, don't rely on a friend's experience at a different school as your baseline. Check our dedicated breakdowns on HESI A2 pricing and testing windows and deadlines for how to find the numbers that apply to your specific application.
| Section | Core Skill Tested | Typical Use in Admissions |
|---|---|---|
| Mathematics | Conversions, ratios, dosage-style calculations | Predicts readiness for dosage calculation coursework |
| Reading Comprehension | Main idea, inference, detail extraction | Predicts ability to process clinical reading materials |
| Vocabulary and General Knowledge | Medical and general word recognition | Predicts comfort with clinical terminology |
| Grammar | Written English mechanics | Predicts documentation and communication skills |
| Biology | Cell and organism-level science | Predicts foundation for physiology coursework |
| Chemistry | General chemistry principles | Predicts foundation for pharmacology coursework |
| Anatomy and Physiology | Body systems knowledge | Predicts foundation for core nursing science courses |
Because every program sets its own passing benchmark rather than using one standardized cutoff, "passing" the HESI A2 really means meeting your specific school's score requirement. Our HESI A2 Passing Score guide walks through how to find and interpret that number for your application, and our HESI A2 Pass Rate breakdown explains what published data does and doesn't tell you about your odds.
A Domain-by-Domain Study Timeline
Generic study techniques - spaced repetition, timed drills, short daily review blocks - work well for the HESI A2 specifically because the exam is section-based: you can isolate weak domains and hammer them independently rather than studying "for the test" as a blob. Structure your prep around the sections your program actually requires, and let the science sections (Biology, Chemistry, Anatomy and Physiology) get more calendar time since they typically involve the most memorization-heavy content.
Diagnostic and Math Foundations
- Take a full diagnostic covering only your required sections
- Rebuild conversion and ratio-proportion skills in Mathematics
- Log every missed question by domain, not just by score
Language Sections
- Drill Grammar mechanics daily in short bursts
- Practice timed Reading Comprehension passages
- Build a running Vocabulary and General Knowledge word list from root words
Biology and Chemistry Core Concepts
- Review cell structure, genetics basics, and metabolism
- Work through periodic table trends and bonding rules
- Use flashcards for high-frequency terms in both sections
Anatomy and Physiology Deep Dive
- Study body systems in the order most emphasized by your program
- Connect physiology concepts back to Chemistry and Biology review
- Take a second full-length timed practice run
Full Simulation and Gap Closing
- Simulate test-day conditions, including your school's proctoring format
- Retest only the domains still below your target benchmark
- Review calculator policy and logistics with your program
For a broader sense of how demanding this preparation load actually is compared to other admissions exams, see How Hard Is the HESI A2 Exam?. If you want a compact final-review reference to carry through week five, our HESI A2 Cheat Sheet condenses the highest-yield facts across all seven sections onto one page.
Question Format and What Test Day Feels Like
Expect straightforward multiple-choice items within each section, delivered through the same platform your school configures for timing and proctoring. Because calculator access is set at the program level rather than being universal, some candidates will do Mathematics questions by hand while others are permitted an on-screen or physical calculator - never assume either way until you've confirmed your school's setting.
Sections run independently with their own time allotments, so pacing discipline matters within each section rather than across the whole exam. A slow start in Grammar, for example, won't necessarily eat into your Anatomy and Physiology time, but it can leave you rushing the back half of that same section. Practicing under a realistic per-section clock - using timed drills that mirror your school's configuration - is more useful than practicing with unlimited time and hoping speed comes naturally on exam day.
Mistakes That Cost First-Attempt Passers
- Studying sections you won't be tested on. Confirm your program's required sections before building a study plan around all seven.
- Assuming one passing score applies everywhere. Each school sets its own benchmark, retake rules, and score-use policy - verify yours directly.
- Skipping the current official reference. The 2024 Admission Assessment Exam Review, 6th Edition is the current official preparation reference and should anchor your content review.
- Under-practicing Anatomy and Physiology and Chemistry. These sections carry the heaviest memorization load for most candidates and reward early, repeated review over last-minute cramming.
- Not confirming the proctoring format in advance. Onsite and remote sessions through the Elsevier Secure Browser have different logistics, and discovering the difference on test day creates avoidable stress.
If you're still weighing whether investing serious prep time into this exam makes sense for your career path, our ROI analysis of the HESI A2 and our overview of nursing career earnings after admission put the time investment in context. Once you're ready to start practicing under real section timers, try a full-length practice test to see where your domain scores stand before you build a final review plan.
Key Takeaway
Run at least one complete practice session under your program's exact section timer and calculator rules before test day - configuration surprises, not content gaps, sink otherwise well-prepared candidates.
Consistent, section-by-section practice on a realistic practice platform lets you convert the diagnostic data from week one into a targeted plan instead of re-reading content you've already mastered. Track your accuracy by domain each time you test, and stop adding new material once a section stays consistently above your program's benchmark across multiple practice attempts. For a condensed refresher in the final days before your appointment, revisit timed practice sets covering just your weakest one or two sections rather than restarting a full review.
Frequently Asked Questions
The question content comes from the same Elsevier-administered platform, but each school chooses which of the seven sections to include and sets its own passing benchmark, retake rules, and score-use policy. Always confirm your specific program's requirements rather than assuming a standard format.
It depends on your program. The full academic content pool includes Mathematics, Reading Comprehension, Vocabulary and General Knowledge, Grammar, Biology, Chemistry, and Anatomy and Physiology, but most schools require only a subset, sometimes alongside an optional Learning Style, Personality Style, or Critical Thinking component.
Calculator access is configured by each school, so it isn't universal. Confirm directly with your program whether a calculator is permitted before you finalize your study approach for conversions and ratio-proportion problems.
The current official preparation reference is Admission Assessment Exam Review, 6th Edition, published in 2024. Pairing that reference with targeted, timed practice by section is the most direct way to prepare.
No. The HESI A2 is an admissions assessment, not a renewable certification, so there's no recertification cycle. Your school's score-use policy determines how long a given result remains valid for admission purposes.