The Ultimate HESI A2 Study Guide:
How to Score 90% or Higher

The Health Education Systems Incorporated Admission Assessment — better known as the HESI A2 — is one of the most important exams a prospective nursing student will ever take. With acceptance into nursing programs often hinging on HESI scores, understanding how to prepare effectively is not optional; it is essential. In this comprehensive guide, we break down every section of the HESI A2, share proven study strategies, and give you a concrete 6-week plan used by our students who consistently score 90% or higher.

What Is the HESI A2 Exam?

The HESI A2 is a standardized nursing school entrance exam administered by Elsevier. It is designed to assess an applicant's readiness for nursing school and academic performance potential. Different nursing programs require different sections, but a typical full exam includes:

• Mathematics — arithmetic, fractions, decimals, ratios, basic algebra
• Reading Comprehension — main idea, inference, vocabulary in context
• Vocabulary & General Knowledge — medical and general vocabulary
• Grammar — parts of speech, sentence structure, punctuation
• Biology — cell biology, genetics, metabolism, homeostasis
• Chemistry — atomic structure, periodic table, chemical reactions
• Anatomy & Physiology — all body systems in depth
• Physics (required by some schools) — motion, fluids, thermodynamics
• Learning Style Inventory — not scored, identifies your learning preferences
• Personality Profile — not scored, assesses professional suitability

Understanding HESI A2 Scoring

Each section of the HESI A2 is scored on a scale from 0% to 100%. There is no overall composite score — schools typically review individual section scores. Most nursing programs require a minimum score of 75–80% per section, though competitive programs often expect 85–90%.

Score Range	Classification	Typical Acceptance
95–100%	Exceptional	All programs
90–94%	Excellent	Most competitive programs
85–89%	Very Good	Majority of programs
80–84%	Good	Many programs
75–79%	Satisfactory	Minimum at most schools
Below 75%	Needs Improvement	Most schools will not accept

Section-by-Section Breakdown and Strategies

1. Mathematics (55 questions, 50 minutes)

The math section covers foundational arithmetic through basic algebra. The most common areas tested are fractions and decimals, ratio and proportions, percentages, basic algebra, unit conversions, and military time. Many students lose points not because they don't know the material, but because they rush. Here is the winning approach:

• Write out your work. Never do mental calculations for multi-step problems.
• Memorize fraction-to-decimal equivalents (e.g., 1/4 = 0.25, 3/8 = 0.375).
• Practice dosage calculation problems daily, since these appear frequently.
• Brush up on Roman numerals — HESI loves them for medication questions.

2. Reading Comprehension (47 questions, 60 minutes)

This section presents passages followed by multiple-choice questions. The key insight most students miss: the answer is always in the passage. Do not rely on outside knowledge. Follow this process for every question: read the question first, then skim the passage for the answer, and eliminate wrong answers systematically. Practice active reading — annotate passages by underlining main ideas and circling transition words.

3. Vocabulary & General Knowledge (50 questions, 50 minutes)

The vocabulary section is heavily weighted toward medical terminology. Students who dedicate two weeks to medical vocabulary flashcards see dramatic score improvements. Focus on prefixes and suffixes — understanding that "cardio" means heart or "itis" means inflammation allows you to decode unfamiliar terms during the exam. Key vocabulary roots to master include: brady, tachy, hypo, hyper, peri, endo, exo, angio, hepat, nephr, oste, and derm.

4. Grammar (55 questions, 50 minutes)

Grammar catches many students off guard because it goes beyond basic writing skills. The exam tests subject-verb agreement, pronoun-antecedent agreement, correct use of apostrophes, comma rules, dangling modifiers, and parallel structure. Study grammar rules systematically and practice with HESI-style sample questions rather than general English exercises.

5. Biology (25 questions, 25 minutes)

Biology focuses on cell structure and function, cell division (mitosis and meiosis), genetics (including Mendelian inheritance and Punnett squares), metabolism, DNA and RNA structure, and the scientific method. Create concept maps that connect related topics — for example, trace how a gene becomes a protein from DNA to mRNA to amino acid chain.

6. Chemistry (25 questions, 25 minutes)

The chemistry section tests atomic structure, the periodic table, bonding, solutions and concentrations, chemical reactions, and pH and acids/bases. Focus particular attention on pH since it is frequently tested in the context of clinical nursing scenarios. Know that a pH below 7 is acidic, above 7 is basic, and 7 is neutral.

7. Anatomy & Physiology (25 questions, 25 minutes)

Anatomy & Physiology (A&P) is the section that separates high scorers from average scorers. The breadth of material is enormous, covering all major body systems. Prioritize these high-yield systems: cardiovascular, respiratory, musculoskeletal, nervous, endocrine, digestive, urinary, and reproductive. Use labeling diagrams and mnemonics aggressively. For example: "Never Let Monkeys Eat Bananas" for the cranial bones (Nasal, Lacrimal, Maxillary, Ethmoid, Zygomatic — plus Frontal, Parietal, Temporal, Occipital, Sphenoid).

Your 6-Week HESI A2 Study Plan

The key to this schedule is daily consistency. Studying for two focused hours every day is far more effective than occasional marathon sessions. Your brain consolidates information during sleep, so spreading study across multiple days dramatically improves retention and recall under exam pressure.

Top Resources for HESI A2 Preparation

Not all study resources are created equal. Based on our experience working with thousands of successful nursing students, these are the resources that deliver the highest return on your study time:

1. Elsevier's Official HESI Admission Assessment Exam Review — The official review book is your bible. Study it cover to cover.
2. Wonderful Solutions HESI A2 Complete Study Guide — Our 284-page guide includes section-specific practice questions, answer rationales, and test-taking strategies not found in the official book.
3. Pocket Prep HESI Prep App — Excellent for vocabulary and quick daily practice on mobile.
4. Khan Academy — Free and exceptional for Biology and Chemistry refreshers.
5. AnkiApp with custom decks — Use spaced repetition for vocabulary and A&P terminology.

Test Day Strategies That Make a Real Difference

Preparation counts for 80% of your result; test day strategy accounts for the other 20%. Follow these rules on exam day:

• Sleep 8 hours the night before. Sleep deprivation reduces cognitive performance by up to 40%. No last-minute cramming.
• Eat a balanced breakfast. Your brain runs on glucose. A meal with protein, healthy fat, and complex carbohydrates stabilizes blood sugar and sustains focus.
• Arrive 30 minutes early. Being rushed creates anxiety that directly impairs test performance.
• Read every question completely before answering. The last word of a question often changes the entire meaning.
• Flag and return to difficult questions. Never get stuck. Move on and return with fresh eyes.
• Trust your first instinct unless you have a concrete reason to change your answer. Second-guessing introduced by anxiety is statistically harmful to your score.

Common HESI A2 Mistakes and How to Avoid Them

After reviewing thousands of student preparation journeys, these are the most common mistakes we see — and how to fix them:

1. Skipping the diagnostic test. Students who skip the initial diagnostic score 12% lower on average because they waste time studying content they already know instead of filling actual knowledge gaps.
2. Over-relying on YouTube. Video is great for visual concepts, but it creates passive learning. Always follow up videos with active recall practice.
3. Ignoring grammar. Grammar is one of the most improvable sections in a short time. Students who dedicate just 30 minutes per day to grammar for two weeks routinely see 15–20 point improvements.
4. Not simulating real test conditions. At least twice in your final week, take a full-length practice test with no distractions, timed sections, and no phone. Your body needs to practice performing under pressure.
5. Studying everything equally. Not all sections carry the same weight at all schools. Know what your target program requires and allocate study time proportionally.

How Wonderful Solutions Can Help

Our HESI A2 preparation program includes a complete 284-page study guide, six full-length practice tests with detailed answer explanations, an Anatomy & Physiology video series (8 videos, 3.5 hours), and 320 medical vocabulary flashcards. Our students who use the complete program average a 91.3% score across all sections — well above the 75% minimum required by most programs.

Whether you have six weeks or two weeks until your exam, our materials are designed to maximize every hour of your study time. Visit our Study Materials page to access all HESI A2 resources, or browse our expert-led courses for personalized preparation support.

Conclusion

Scoring 90% or higher on the HESI A2 is absolutely achievable with the right preparation strategy, the right resources, and consistent daily effort. Understand the exam structure, diagnose your weaknesses, follow a structured study plan, and simulate real test conditions. The students who succeed are not necessarily the smartest — they are the most strategic and the most consistent. You have everything you need to join them. Start today.