HESI vs TEAS: Which Exam Should Nursing Students Take?

If you are researching nursing programs, you have probably seen both the TEAS and the HESI A2 listed as admission requirements. A HESI vs TEAS comparison is one of the first things prospective nursing students search for once they see either exam on an admissions checklist. These two exams measure similar academic foundations, but they are built differently, scored differently, and required by different programs.

This guide breaks down every meaningful difference between the ATI TEAS (also known as the ATI TEAS 7) and the HESI A2: how each exam is structured, which content areas each covers, how scoring works, what each exam costs, and how to decide which one to study for if your program requires a specific test.

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TEAS vs HESI: What Each Exam Tests

The ATI TEAS (Test of Essential Academic Skills) is published by Assessment Technologies Institute, a division of Ascend Learning.

Nurse.org's Expert's Advice

"The HESI and TEAS exams have become the standard for entrance into nursing schools and play a significant part in the decision-making process. Schools can see how students score and how they perform on standardized tests. This can help be a predictor of their success in the program."

Kathleen Gaines

MSN, RN, BA, CBC

Nurse.org News and Education Editor

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It is currently in Version 7, which launched in 2022. More than two-thirds of nursing programs in the United States use the TEAS as part of their admissions process.

The exam is standardized nationally, which means every test-taker sits for the same structured sections in the same order.

The HESI A2 (Health Education Systems Incorporated Admissions Assessment) is published by Elsevier. Unlike the TEAS, the HESI is modular: each nursing program chooses which sections students must complete.

A school using the Elsevier educational platform may require six of the eight available subject areas, while another school using the same exam may only require four. This flexibility is a defining feature of the HESI A2 and one of the biggest structural differences between the two exams. For a deeper overview of each exam on its own, see what the TEAS exam tests and how to prepare, as well as our HESI A2 exam guide.

TEAS vs. HESI: Full Comparison at a Glance

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How the ATI TEAS Is Structured

The TEAS test has a fixed structure: every test-taker completes the same four sections in the same order. Reading comes first, followed by Mathematics, Science, and English and Language Usage. You cannot skip a section or change the order.

The full section breakdown is below:

Twenty of the 170 questions are unscored pretest items that ATI uses to evaluate potential future questions. You will not be told which questions are unscored, so it is best to treat all 170 as if they count.

The TEAS uses five question formats, not just standard multiple choice.

1. Multiple choice (one correct answer from four options) makes up the majority of the exam.
2. Multiple select requires you to choose all correct answers, with no partial credit.
3. Fill-in-the-blank, also called supply answer, asks you to type a calculated answer without any choices given.
4. Hot spot questions show an image and ask you to click the correct region.
5. Ordered response questions ask you to drag items into the correct sequence. You can find full-length practice with all five formats through our TEAS prep platform.

How the HESI Is Structured

The HESI A2 has eight subject areas, but your nursing program decides which sections you must complete. Most programs require six of the eight: reading comprehension, vocabulary, grammar, math, biology, and anatomy and physiology. Chemistry and physics are required less often, though some programs do include them.

Here is the full breakdown of all eight HESI A2 sections:

If your program requires all eight sections, you will answer up to 326 questions in approximately four hours. Most test-takers complete fewer sections. The HESI A2 uses primarily multiple-choice questions throughout, which is a simpler format than the TEAS but does not reduce the depth of content knowledge required.

One important note: because each program chooses its own required sections, two students applying to different schools can sit for very different versions of the HESI A2. Always confirm exactly which sections your target school requires before you start studying.

Bottom line: The TEAS has a fixed national format that every test-taker completes the same way. The HESI is customized by each nursing program, so your actual exam depends entirely on which sections your school requires.

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Is the TEAS Harder Than the HESI?

There is no single correct answer, because difficulty depends on your individual academic background and knowledge. That said, there are concrete differences in structure and content that make each exam challenging in different ways.

The TEAS tends to be more demanding in terms of question complexity. Its five-question formats, including hot spots, ordered response, and fill-in-the-blank, require you to produce or navigate answers rather than just select from a list. The Science section, with 50 questions covering anatomy, physiology, biology, chemistry, and scientific reasoning in 60 minutes, is frequently cited by students as the hardest part of any nursing entrance exam.

The HESI A2 covers more subject areas but uses simpler question formats (primarily multiple choice). Students who struggle with breadth rather than depth often find the HESI more demanding. The Vocabulary section alone tests 50 words in 50 minutes, many of them health-specific terms that general test-takers will not recognize without deliberate study. Students who have not taken a Physics course may also struggle with that section if their program requires it, since Physics does not appear on the TEAS at all.

Here is how the two exams compare on the factors that most affect perceived difficulty:

Students who are strong in science and math but weaker in vocabulary and grammar may find the HESI harder. Students who perform well on standardized reading and writing but struggle with complex question formats may find the TEAS harder. Your personal academic strengths matter more than any blanket “which exam is harder” explanation.

Bottom line: Neither exam is objectively harder for every student. The TEAS has more complex question formats and a demanding science section. The HESI A2 tests more subject areas and includes vocabulary and physics not found on the TEAS. Your background determines which feels more difficult.

How TEAS and HESI A2 Scoring Works

The two exams use completely different scoring systems. Understanding both helps you interpret practice test scores and know what your target school is actually looking for.

The TEAS reports scores as a percentage from 0 to 100. ATI uses four performance levels to describe where your composite score falls:

The HESI A2 uses a 100 to 1000 point scale. Rather than national performance tiers, each nursing program sets its own required score. Many programs also look at section-level scores individually, not just the overall composite, which is why you should always verify the exact minimum directly with admissions.

You receive TEAS results almost immediately when testing through ATI, or within 48 to 72 business hours, depending on location. HESI results are typically available shortly after exam completion, with a remediation plan delivered within two weeks. To understand what score your specific program expects, compare nursing program admission requirements directly, or contact admissions at each school you are applying to.

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TEAS vs. HESI A2: Cost and Retake Policies

The TEAS costs $81 when registered directly through ATI. Some institutions include the exam fee as part of their application process, while others require you to pay out of pocket. Testing at a PSI center may carry different fees. Verify current pricing at atitesting.com before registering, as fees may change.

HESI A2 costs vary more widely because Elsevier's pricing model depends on the institution. Some schools cover the exam cost entirely, while others require students to pay a testing fee. Contact your target program's admissions office to confirm the current fee before you register.

Retake policies also differ between the two exams and between programs:

Before retaking either exam, confirm your specific program's retake rules. Some schools count every attempt in their admissions review, while others only look at the most recent score. Knowing the policy before you register saves you time and money.

Which Nursing Programs Require the TEAS vs. HESI?

The short answer is that you rarely choose between the TEAS and the HESI. Your target nursing program makes that decision for you.

The TEAS is used by a majority of nursing programs nationwide. ATI partners with more than two-thirds of U.S. nursing schools, making it the most common exam across ADN and BSN programs.

The HESI is most common at schools using Elsevier's Evolve learning platform. Some regions have a higher concentration of HESI-requiring schools. A small number of programs accept scores from either exam, letting applicants submit whichever they have earned.

Here is a general breakdown of who uses each exam:

Nurse.org's Expert's Advice

"Students shouldn’t pick nursing programs based on whether a school requires the HESI or TEAS exam. Students should focus on picking a nursing school that meets their needs, including academic success, financial factors, and overall experience."

Kathleen Gaines

MSN, RN, BA, CBC

Nurse.org News and Education Editor

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The only reliable way to know which exam you need is to check with each program you plan to apply to. Many programs list entrance exam requirements on their admissions page. If you are applying to multiple schools and they require different exams, you may need to prepare for both. The content overlap between the two exams (reading, math, science, and English) means that studying for one will give you a strong foundation for the other.

Bottom line: Research each program you are applying to before you start studying. If your top-choice school requires the TEAS, start there. Preparing for one exam builds skills that transfer directly to the other if you need to take both.

How to Prepare for the TEAS or HESI

Both exams require structured preparation. Most students benefit from six to eight weeks of focused study, with more time allocated to their weakest subjects. Take a diagnostic practice test before you begin studying so you know exactly where to focus.

For the TEAS, your study plan should include all five question formats, not just multiple choice. Hot spot and ordered response questions trip up students who only practice standard questions. The Science section typically requires the most time, especially if you have not taken anatomy, biology, or chemistry recently.

For the HESI A2, confirm which sections your program requires before building your study plan. Then focus only on what your school tests:

• Skip Physics preparation if your school does not require it.
• Study health-specific vocabulary deliberately; many terms are clinical and not found in everyday reading.
• Review grammar rules; Grammar is a separately scored section on the HESI with no direct equivalent on the TEAS.

Whichever exam you take, use these four steps to structure your preparation:

1. Take a full-length practice test first to establish a baseline score.
2. Review every wrong answer and every question you guessed on, reading the explanation for each.
3. Allocate study time based on your lowest-scoring sections, not your favorites.
4. Take a second full practice test two to three weeks before your exam to measure progress.

For additional guidance on building an effective study schedule for the TEAS, see how to study for the TEAS exam.

FAQs

• Can I Choose Between the TEAS and the HESI, or Does My School Decide?

  • Your nursing program decides which exam it requires. Most programs accept only one or the other. A small number of programs accept scores from either exam. Check the admissions requirements for each school you plan to apply to before registering for either test.

• Which Exam Covers More Content, the TEAS or the HESI?

  • The HESI A2 covers more subject areas overall, with up to eight sections including separate vocabulary, grammar, biology, anatomy and physiology, chemistry, and physics sections. The TEAS combines English grammar and vocabulary into one section and integrates biology and chemistry into its Science section. The breadth of the HESI A2 is wider, but what you actually face depends on which sections your program requires.

• Is the Science Section the Same on Both Exams?

  • Not exactly. The TEAS Science section has 50 questions covering human anatomy and physiology (the largest portion), biology, chemistry, and scientific reasoning, all in 60 minutes as one combined section. The HESI A2 splits this content into separate Biology (25 questions) and Anatomy and Physiology (25 questions) sections, with Chemistry as a third optional section. The TEAS format is more time-pressured, while the HESI divides the content into smaller, more focused tests.

• How do TEAS and HESI Scores Compare When Applying to Nursing School?

  • You cannot directly convert a TEAS score to a HESI A2 score because the scales are completely different. The TEAS uses a 0-100% percentage scale with four national performance tiers. The HESI A2 uses a 100-1000 scale with program-specific passing thresholds. Each school evaluates only the exam it requires, so comparing scores across the two exams is not something admissions offices typically do.

• Do the TEAS and HESI Have the Same Retake Policy?

  • No. The TEAS has a 14-day minimum wait between attempts when testing through ATI directly, and institutions commonly require 30 days. HESI A2 retake policies are set by each institution, so the wait period and allowed number of attempts can differ from school to school. Always check your specific program's policy before scheduling a retake.

• If I Score Well on One Exam, Does That Mean I Will Score Well on The Other?

  • Your underlying academic skills transfer between the two exams, but the format differences can affect your performance in ways your score may not predict. If you scored high on the TEAS, you likely have strong science and reading skills that will help on the HESI. However, the HESI's dedicated Vocabulary and Grammar sections require specific preparation that the TEAS does not directly test. A high TEAS score is a good foundation, but it is not a substitute for preparing specifically for the HESI format and content.

• HESI vs TEAS: Which Exam Should I Prioritize?

  • Priortize  the exam that your target nursing program actually requires. If you are applying to multiple schools that require different exams, start with the one your first-choice program uses. Because the TEAS and HESI A2 share core content in reading, math, and science, studying for one builds a strong foundation for the other.

This article is for informational purposes only. Nursing program admission requirements, exam fees, and retake policies vary by institution and may change. Always verify specific requirements directly with your target nursing program. Nurse.org does not guarantee admission to any nursing program.