A HESI practice exam is the fastest way to find out where you stand before a HESI test, whether that is the HESI A2 entrance exam for nursing school, a HESI specialty exam during your program, or the HESI Exit Exam before the NCLEX. This guide explains every type of HESI exam, what each one covers, how scoring works, how to register, and how to prepare, with a study plan, original sample questions and links to all of our free HESI practice tests.
| HESI at a glance | |
|---|---|
| Full name | Health Education Systems, Inc. (HESI®) exams |
| Published by | Elsevier |
| Main exam types | Admission Assessment (A2), Specialty exams, Exit Exam (RN and PN), CAT, Custom and Mobility exams |
| Who uses it | Nursing and health professions programs, for admission, course testing and NCLEX readiness |
| Scoring | HESI scores with a recommended benchmark of 850 on most specialty and exit exams; A2 scores are percentages |
| Where | In person at your school or a testing site, or with live remote proctoring, as your program decides |
| Who sets the rules | Your nursing program chooses the exams, sections, passing scores and retake policy |
Table of Contents
What Is the HESI Exam?
HESI stands for Health Education Systems, Inc., the company that created the exams. HESI is now part of Elsevier. It is not one single test: it is a family of computer-based exams that nursing schools use at every stage of a program, from choosing applicants to checking that graduates are ready for the NCLEX.
Because each school buys and configures its own HESI exams, two students can face different versions. Your program decides which sections you sit, how long you get, what score you need and how many attempts you are allowed. Always check your school’s HESI information first, then use this guide and our practice tests to prepare.
Types of HESI Exams
| HESI exam | When you take it | What it measures |
|---|---|---|
| HESI A2 (Admission Assessment) | Before nursing school | Academic readiness in math, English and science, plus optional learning-style and personality profiles |
| HESI Specialty exams | During your program, usually at the end of a course | Knowledge of one content area, such as fundamentals, pharmacology, med-surg, maternity, pediatrics or mental health |
| HESI Exit Exam (RN or PN) | Final semester, before the NCLEX | Overall readiness for the NCLEX-RN or NCLEX-PN |
| HESI CAT exam | Near graduation | NCLEX-style computer adaptive testing, where questions adapt to your answers |
| HESI Mobility exams | Before an LPN-to-RN, LPN-to-ADN or RN-to-BSN bridge | Prior nursing knowledge for advanced placement |
| Custom and Mid-Curricular exams | Any point in the program | Content built around your school’s own curriculum |
| HESI Clinical Practice Readiness (CPRA) | Late in the program | Clinical judgment through screen-based patient simulations |
Elsevier also offers HESI exams for health professions such as dental hygiene, EMT/paramedic, medical assisting, radiography, respiratory care and surgical technology. This guide focuses on the nursing exams.
HESI A2 Entrance Exam
The HESI A2, also called the HESI Admission Assessment or HESI entrance exam, is the test most nursing applicants mean when they search for a HESI entrance exam practice test. Schools use it to rank applicants. Most programs require only some of the sections below, so confirm your list before you study.
| A2 section | Questions* | Time* | What it covers |
|---|---|---|---|
| Reading Comprehension | 47 | 60 min | Main idea, inferences, purpose, vocabulary in context, drawing conclusions from health passages |
| Vocabulary & General Knowledge | 50 | 50 min | Health-care and general vocabulary |
| Grammar | 50 | 50 min | Parts of speech, sentence structure, common usage errors |
| Math | 50 | 50 min | Fractions, decimals, ratios and proportions, percentages, conversions, military time, Roman numerals, basic algebra |
| Biology | 25 | 25 min | Cells, biological molecules, metabolism, cellular respiration, photosynthesis, genetics |
| Chemistry | 25 | 25 min | Atomic structure, the periodic table, bonding, reactions, acids and bases, the metric system |
| Anatomy & Physiology | 25 | 25 min | Terminology, body systems, anatomical planes and directions, histology |
| Physics | 25 | 50 min | Motion, Newton’s laws, gravity, friction, energy, light and optics |
*Figures as commonly reported (see Nurse.org’s HESI exam guide). Counts and times can differ by school because programs choose and configure sections. Many schools also add unscored Learning Style and Personality Profile surveys.
HESI A2 practice tests by section
- Math: HESI A2 Math practice test
- Reading: HESI A2 Reading Comprehension practice test
- Vocabulary: HESI A2 Vocabulary practice test
- Grammar: HESI A2 Grammar practice test
- Admission med-surg (BSN/ASN): HESI Admissions BSN/ASN Medical-Surgical
- Question banks: A2 Biology, A2 Anatomy, A2 Reading, A2 Vocabulary and A2 Grammar
HESI LPN-to-ADN and LPN entrance exams
If you are already an LPN, your bridge program may use a HESI Mobility (LPN-to-RN or LPN-to-ADN) exam instead of, or as well as, the A2. These test nursing content such as fundamentals, pharmacology, med-surg and maternal-child nursing, so prepare with the specialty practice tests below rather than A2 English and math alone.
HESI Specialty Exams
Specialty exams test one subject at a time and are often worth part of your course grade. They use NCLEX-style questions, so practising them also builds the skills you need for the Exit Exam. Here are our free HESI practice exams for each specialty:
| Specialty | Free practice tests |
|---|---|
| Fundamentals / Foundations | Foundations of Nursing Final 2026, Foundations of Nursing Exam 2 |
| Pharmacology | HESI RN Pharmacology, HESI Pharmacology 2025 |
| Medical-Surgical | HESI RN Med-Surg 2026, BSN 266 RN Med-Surg, Med-Surg Adult Health I & II |
| Pediatrics and Women’s Health | Set 1, Set 2, Set 3 |
| Mental Health | HESI Psychiatric and Mental Health Nursing |
| Health Assessment | HESI RN Health Assessment |
| Nutrition | HESI Nutrition (WGU) |
| Mixed practice | HESI Practice Questions, HESI Exam Questions, HESI Examination |
HESI Exit Exam (RN and PN)
The HESI Exit Exam is a comprehensive test taken in your final semester. It follows the current NCLEX test plan and question formats, so it is the closest thing to an NCLEX dress rehearsal. Many programs require a minimum Exit score to graduate or to be cleared to sit the NCLEX.
- Length: the RN Exit is commonly reported at about 150 questions; PN Exit versions are commonly 150 or 75 questions. Your school sets the time limit.
- Content: the nursing process and NCLEX client-needs categories (management of care, safety and infection control, health promotion, psychosocial integrity, basic care, pharmacology, risk reduction and physiological adaptation) across all specialties.
- Question types: multiple choice, select-all-that-apply, fill-in-the-blank calculations, ordered response, hot spots and Next Generation NCLEX (NGN) case-study items.
- Predictive value: Elsevier reports a predicted first-attempt NCLEX pass rate of 96% or higher for students who score 850+ on the HESI Exit (Elsevier).
HESI Exit practice tests
- HESI Exit Exam practice test
- HESI Exit Exam (Set 2)
- Exit HESI Exam
- Exit HESI
- HESI Exit Q&A
- PN Exit / final: HESI PN Final Exam
- Question bank: HESI Exit question bank
HESI Scores Explained
HESI uses two kinds of results:
- A2 entrance exam: a percentage score for each section and a composite score. Many schools look for 75% to 80% or higher, but each program sets its own minimum and may weigh some sections more than others.
- Specialty and Exit exams: a HESI score, which weights each question by difficulty, plus a conversion score that some schools use as a course grade. Elsevier’s recommended benchmark is 850, and many schools set their passing score at 850 or 900.
After each exam you receive a report with your weakest areas and personalized remediation from Elsevier. Use it to decide what to practise next.
How to Register for a HESI Exam
- Ask your program which HESI exam and sections you need, the passing score, and whether you test on campus, at a testing center or remotely.
- Create or sign in to your Elsevier Evolve student account.
- Register for the exam with the details or payment method your school gives you. Fees vary by school and exam type.
- Check the ID, computer and room rules for your testing format.
- Find your results and remediation in Evolve after the exam.
How to Study for the HESI: A 6-Week Plan
| Week | Focus |
|---|---|
| 1 | Take a full HESI practice exam under timed conditions to get a baseline. List your three weakest areas. |
| 2 | A2: math and reading. Specialty/Exit: fundamentals and pharmacology. Do 25–50 practice questions a day. |
| 3 | A2: vocabulary and grammar. Specialty/Exit: med-surg. Review every rationale, including for questions you got right. |
| 4 | A2: biology, chemistry and A&P. Specialty/Exit: maternity, pediatrics and mental health. |
| 5 | Mixed timed sets from all areas. Revisit your weakest topics from week 1. |
| 6 | Take a second full practice exam, review the results, then rest the day before your test. |
- Learn why each answer is right. HESI questions test application, not just recall.
- For priority questions, use ABCs (airway, breathing, circulation), Maslow’s hierarchy and safety first.
- Practise dosage calculations without shortcuts and always check units.
- Do some sets on a computer screen with a timer to get used to the format.
HESI Sample Questions
These are original HESI-style practice questions written for this guide. Try each one, then open the answer.
Sample 1: A2 Math
A patient drinks 1 1/2 cups of juice. One cup holds 240 mL. How many milliliters did the patient drink?
- 240 mL
- 300 mL
- 360 mL
- 480 mL
Show answer and explanation
Answer: C
1.5 × 240 mL = 360 mL.
Sample 2: A2 Grammar
Which sentence is grammatically correct?
- Each of the nurses have a locker.
- Each of the nurses has a locker.
- Each of the nurses are having a locker.
- Each of the nurse has lockers.
Show answer and explanation
Answer: B
“Each” is singular, so it takes the singular verb “has”. “Of the nurses” does not change the subject.
Sample 3: A2 Vocabulary
The patient’s symptoms were transient. What does transient mean?
- Lasting a short time
- Getting worse
- Spreading to other areas
- Caused by infection
Show answer and explanation
Answer: A
Transient means temporary or short-lived.
Sample 4: Fundamentals
A client on bed rest has a reddened area over the sacrum that does not blanch. What should the nurse do first?
- Massage the area
- Reposition the client off the sacrum
- Apply a heating pad
- Document the finding at the end of the shift
Show answer and explanation
Answer: B
Non-blanchable redness is a stage 1 pressure injury. Relieving pressure comes first. Massage can damage tissue further, and heat increases metabolic demand.
Sample 5: Pharmacology
A client taking warfarin asks which food to eat in consistent amounts. Which food should the nurse mention?
- Bananas
- Spinach
- White rice
- Chicken
Show answer and explanation
Answer: B
Leafy greens such as spinach are high in vitamin K, which affects warfarin. The client should keep vitamin K intake consistent rather than avoid it.
Sample 6: Exit (prioritization)
Which client should the nurse assess first?
- A client with COPD whose oxygen saturation is 91%
- A post-operative client with new restlessness and a respiratory rate of 30
- A client with diabetes whose blood glucose is 180 mg/dL
- A client asking for pain medication rated 4/10
Show answer and explanation
Answer: B
New restlessness with rapid breathing suggests hypoxia or another acute change. A saturation of 91% can be expected in COPD, and the other two clients are stable.
Free HESI Practice Test Resources
| Resource | What it includes |
|---|---|
| HESI Exam Complete Guide | Background on each HESI exam |
| HESI practice questions | Free mixed HESI practice set |
| HESI A2 practice tests | Free A2 math, reading, vocabulary and grammar sets |
| HESI Exit practice tests | Free Exit Exam sets with answers |
| HESI question banks | Downloadable HESI question banks in the GradeHustler shop |
| Elsevier HESI | Official HESI exam information and review products |
Looking for a HESI exam practice test PDF? Our shop question banks can be downloaded, and every free practice post above can be printed or saved from your browser.
HESI Exam Day Tips
- Confirm the time, place or remote-proctoring setup, and the ID you need, the day before.
- Arrive early, or log in early for remote testing so the system check does not cut into your time.
- Use the on-screen calculator for math; personal calculators are not allowed.
- Read the last line of each question first so you know what it is asking.
- Watch for words like first, best, most and priority.
- Do not leave questions blank; you usually cannot go back once you move on.
HESI Practice Exam FAQ
What is the HESI exam?
HESI is a family of nursing exams from Elsevier used for nursing school admission (A2), course testing (specialty exams) and NCLEX readiness (Exit Exam).
Where can I take a free HESI exam practice test?
GradeHustler has free HESI practice tests for the A2 sections, every major specialty and the Exit Exam. See the links in each section above.
Is the HESI A2 hard?
Most applicants find the content similar to high-school English, math and science. The challenge is the time limits and the number of sections, so timed practice helps most.
What is a good HESI A2 score?
Many schools want 75%–80% or higher, and competitive programs may expect more. Check your school’s minimum for each section.
What is a passing score on the HESI Exit Exam?
Elsevier’s recommended benchmark is 850. Your school sets the actual passing score, and many use 850 or 900.
How many questions are on the HESI Exit Exam?
The RN Exit is commonly about 150 questions, and PN versions are commonly 150 or 75. Your school’s version may differ.
Can I retake the HESI?
Usually yes, but retake limits and waiting periods are set by each school.
Is HESI the same as ATI TEAS?
No. They are different entrance exams from different companies. Your school chooses one. See our ATI TEAS Exam guide if your program uses the TEAS.
HESI® is a registered trademark of Elsevier. NCLEX® is a registered trademark of the National Council of State Boards of Nursing. GradeHustler is an independent study resource and is not affiliated with or endorsed by Elsevier. Exam details can change and vary by school, so confirm current rules with your program and Elsevier.