Getting Through the HESI A2 Without Losing Your Mind
The HESI Admission Assessment (A2) is a computer-adaptive placement exam used by nursing programs across the US. It tests math, reading comprehension, vocabulary, grammar, biology, chemistry, anatomy, and physics. Most people take it before they're allowed to start their nursing prerequisites. You get a certain amount of time per section, and you can retake the whole thing if your school allows it. The timing is the part that catches people off guard. You have roughly 2 minutes per math question, and some sections like reading comprehension give you just 45 minutes for 50 questions. That means you're moving fast. I sat through this exam twice in 2021 while applying to my BSN program. The first time, I bombed the chemistry section because I didn't realize the questions weren't just basic high school chem. They included stoichiometry and molarity calculations that I hadn't touched in three years. I ended up scoring a 68 on that section. The second time, I pulled an 84. The difference wasn't that I became smarter. It was that I stopped using random flashcards and started working through problems under timed conditions.
Hesi Admission Assessment Study Guide
A study guide for the HESI A2 isn't one single book. It's really a collection of resources you put together yourself, because no official HESI study guide exists from Elsevier, the company that makes the exam. What people call a "study guide" is usually a compiled PDF with practice questions, flashcards, and breakdowns of each section. Some are free on forums and GitHub repos. Some you can buy on Amazon or Etsy from third-party sellers. None of them are endorsed by HESI. Here's what I actually used and why it mattered. For math, I worked through the Math for Nursing textbook by Howard Anfinson. It covers the exact topics: fractions, decimals, percentages, ratios, proportions, and drug dosage calculations. The dosage math is the section most people get wrong. You need to know how to convert mg to mL when the concentration is given as something like 500 mg per 2 mL. Practice that until it's automatic. For vocabulary, I used Quizlet sets but only the ones that had 1,000+ terms and were created by nursing students who cited the actual HESI vocab list. The official HESI provides a list of 1,700 words you should know, and it's posted on the Elsevier website. Use that list. Don't use a generic SAT vocabulary list. For the science sections, the resource that actually helped was a combination of a general biology textbook chapter review and a YouTube channel called Level Up RN. Her HESI A2 prep videos walk through each topic at a pace that matches the exam. I watched her anatomy and physiology review first. That section alone is 50 questions and covers everything from cell biology to the endocrine system. Most people skip it because it feels too broad. That's the mistake.
There's also the issue of where people download these materials. A lot of free "HESI A2 study guides" on the internet are just repackaged questions from older test versions. The exam changes its content slightly every year. I found a PDF online that had three chemistry questions about Avogadro's number that don't appear on the current exam format. Wasted an hour studying something that never showed up. Always check the date on whatever resource you're using. Anything pre-2020 is suspect. The reading comprehension section is scored differently than you'd expect. It's not just about understanding the passage. You're also tested on identifying main ideas, making inferences, and recognizing the author's purpose. The passages are medical in nature but the questions are standard reading comp format. I found that skimming the questions before reading the passage saved me time. You can often predict what they're asking for and read with that in mind instead of trying to absorb everything. Grammar is the easiest section to improve quickly. It covers parts of speech, sentence structure, punctuation, and subject-verb agreement. There are only about 30 questions and you get 30 minutes. If you know the basics, you can score in the 90th percentile here without much study. Do a quick review of run-on sentences and comma splices. That's about 60% of the grammar questions right there.
Get the Full Details
One thing nobody tells you about the HESI A2 is that your score is compared to a national norm. A score of 75 is roughly average. Schools typically want a 75 or above on each section, though some competitive programs want 85+. Your weakest section drags down your overall application more than you'd think. I knew my reading and vocab were solid. I spent 70% of my study time on chemistry and math because those were the sections holding me back. That's where the improvement happened. If you're looking for a single downloadable resource to start with, the free HESI A2 practice test on the HESI official site gives you a sense of the question format, though the questions themselves are simplified compared to the real exam. The full-length practice exams you'll find on sites like Quizlet and study guides on Amazon are closer to the actual difficulty level. Just be aware that some of those practice questions use older question banks and may not reflect the current test structure. The physics section is the one most people ignore because it's the smallest part of the exam and they assume it won't matter. It has about 15 questions covering basic concepts like velocity, force, and simple circuits. If you took physics in high school, you'll be fine. If you didn't, spend two hours reviewing the fundamentals. It's low-hanging points.
What I wish someone had told me before I started: take a practice test first without studying. Just see where you stand. I did this and discovered I was scoring around 60 in chemistry and 72 in math before I opened a single book. That told me exactly what to focus on instead of wasting time on sections I already understood. Knowing your baseline saves you weeks of inefficient studying. Another practical detail: the exam is taken at a testing center, not online from home. You need to schedule it through your school or a Pearson VUE center. Plan to arrive 15 minutes early. You'll need two forms of ID. One has to be government-issued. I showed up once with my student ID and a library card. They turned me away. That cost me a full day of lost prep time. The biggest bottleneck with HESI A2 prep is that different nursing programs set different score requirements. Some schools only look at your highest section score. Others average them. Check with your program before you invest heavy study time. If your target school only cares about a 70 overall and you're already scoring 75 in most sections, you don't need to push yourself to 90 everywhere. Be strategic about where you direct your effort.
For those looking for a concrete starting point, here's a basic plan that worked for me over a six-week period. Week one and two: math and chemistry fundamentals. Do three practice sets of each under timed conditions. Week three and four: anatomy, physiology, biology, and chemistry review. Week five: full-length practice exam. Week six: target your weak spots based on the practice exam results. Don't schedule the real test until you've consistently scored above your target program's requirement on practice exams. The HESI A2 doesn't test how much you know. It tests how fast you can apply what you know under pressure. That's the real difference between studying for this exam and studying for any other standardized test you've ever taken.
