What is the HESI Exam and How Do You Prepare for it?

7 Min Read Published August 22, 2023
What is the HESI Exam & How to Prepare for It

What Is the HESI Exam?

The HESI exam is an entrance exam required for many nursing programs. It's a predictor of nursing student success, and many schools use the exam as a part of the admissions criteria for acceptance. Not all colleges and universities use HESI. However, it is becoming more common to help students study and pass their licensure exams. 

There are two main HESI exams - the HESI Admissions (A2) and the HESI Exit Exam.

What Does HESI Stand For?

Health Education Systems Incorporated (HESI) is a company in the United States that helps nurses prepare for and pass their licensure exams. 

HESI A2 vs. HESI Exit Exam


The HESI A2 is a 4-hour exam that some schools give to prospective nursing candidates. Schools may use this test to determine if the applicant qualifies for acceptance into their program. 

Schools may also customize the tests for their program and determine what a passing score is. If you are taking the HESI exam, contact your nursing program for more exam details. 

Sections of the HESI A2 Exam

There are 326 questions of the HESI A2. The test includes nine different sections in the following subjects:

  • Reading: 47 questions
    • Measures the student’s ability to read about medical and health situations and make conclusions
  • Comprehension: 47 questions
  • Vocabulary: 50 questions
    • Basic health-care vocabulary
  • Grammar: 50 questions
  • Math: 50 questions
    • The HESI A2 covers many areas, including addition, subtraction, fractions, ratios, decimals, multiplication, household measures, and dosage calculations
  • Biology: 25 questions
    • This section tests biology basics such as terminology, metabolism, cellular respiration, photosynthesis
  • Anatomy and Physiology: 25 questions
    • Questions on anatomical structures, body systems, and terminology
  • Physics: 25 questions
  • Chemistry: 25 questions
    • May include questions on chemical equations, reactions, bonding, and the periodic table

Keep in mind that schools can change the test by excluding some information. The HESI A2 exam also aims to discover candidates' learning styles, giving schools more information about the student.

HESI Exit Exam

The HESI Exit Exam is a test given by nursing schools that helps determine if a student is prepared to pass the NCLEX exam as they approach graduation. Some schools even use the exam to determine if students will be allowed to graduate.

The company states that the HESI Exit exam predicts whether or not a student will pass the NCLEX exam with 98% accuracy.

HESI RN and LPN Exit Exams

There are 150 questions on the HESI RN EXIT exam. The HESI LPN Exit Exam has either 150 or 75 questions. Both exams aim to assess critical thinking and mimic the respective NCLEX Exams.

As a similar test to the NCLEX, the HESI Exit Exam includes the following types of questions:

  1. Multiple choice
  2. Multiple responses
  3. Fill in the blank
  4. Drag/drop

Nursing school graduates must take and pass the NCLEX to become certified and practice as a nurse. For this reason, schools want to make sure that students can pass their licensure exam following graduation. The subjects on the HESI Exit Exam are all subjects that are studied extensively in nursing schools.

HESI Exit Exam Topics 

The Nursing Process

  • Assessment
  • Nursing Diagnosis
  • Planning
  • Implementation
  • Evaluation

Client Needs

  • Safe and effective environment
  • Management of care
  • Safety
  • Infection control
  • Health promotion 
  • Psychosocial integrity
  • Basic Care and comfort
  • Pharmaceutical and parenteral treatments


  • Nursing fundamentals
  • Geriatrics
  • Medical-Surgical
  • Pediatrics
  • Critical Care
  • Community health
  • Mental Health


How Many Questions Are on the HESI?

There are 326 questions on the HESI A2. Students may have up to 4 hours to complete the exam depending on the nursing program.

The HESI RN Exit Exam has 150 questions, and the HESI LPN Exit Exam has either 150 or 75 questions.

How Many Times Can You Take the HESI Exam?

Students may take the HESI admission exam once every 60 days. However, there is a limit of 3 times per 12 months. Scores are valid for two years.

Can You Use a Calculator for the HESI Exam?

You may not bring your own calculator. You are only allowed to use the calculator provided on your computer screen at exam time. 

What is a Passing Score for the HESI Exam?

Passing scores for the HESI A2 are dependent on your nursing school program. Check with your program to see what passing requirements are. 

HESI Exit Exam scores provide the test taker with a prediction of how they will perform on the NCLEX. Nursing schools may also have their own passing score that students must achieve before graduation. In addition, some schools may only allow students to take the test a certain number of times, most commonly twice.

The HESI website states they can predict NCLEX passing scores with the following exam scoring:

  1. Above 950 - Outstanding pass probability 
  2. 900-940 - Excellent pass probability
  3. 850-899 - Average pass probability
  4. 800-849 - Below average pass probability
  5. 750-799 - Additional prep needed
  6. 700-749 - Serious prep needed
  7. 650-699 - Probability of failing
  8. Below 649 - Expected poor performance

How Much Does the HESI Exam Cost?

HESI exam costs depend on the institution offering the exam. However, they usually range between $40 to $100 or more.

Why Do You Need to Take the HESI Exam?

Many schools require applicants to take the HESI A2 exam as part of their admissions process. As students near graduation, the HESI Exit exam is a way to predict success on the NCLEX exam. The HESI exam also helps students find the areas where they need to improve before taking the NCLEX exam.

How to Register for the HESI Exam

You must register to take any HESI exam, receive test results, register for distance exams, and make payments. To do this, you will also need to create a student account.

  1. Step 1: Set up an account at https://evolve.elsevier.com/cs/ 
  2. Step 2: Select “I’m a student.”
  3. Step 3: On the next screen, select “Register for Distance Testing” 
  4. Step 4: On the next screen, click “Register” and make the payment or provide a promotion code.

Keep in mind that your institution may have other instructions for you regarding making an Elsevier account registering for a HESI exam. Check with your instructors to see if they have any additional requirements for registration.

How to Prepare for the HESI Exam

Studying for the HESI exam might seem like a monumental process now, but if you plan ahead and understand the details about the test, you can succeed! You will likely need to prepare for a HESI exam before being accepted to a nursing program again as you approach graduation.

Here are a few helpful HESI exam tips:

  1. Know what subjects will be on your exam. Each nursing program can decide which parts of the HESI exam they will give students. It is essential to know what they are so that you can focus on areas of importance.
  2. Know how many questions there will be on the test and how long you have to take it.
  3. Understand that you will not receive a traditional letter grade score, but a score from 100-1000. The higher the score, the better; however, each nursing program may have its own criteria for passing the test. Talk to administrators in your program for more details.
  4. Use a HESI study guide.
  5. Use HESI flashcards or make your own.
  6. Have a study schedule.
  7. If you are already in your nursing program, use the HESI practice tests as a way to find your weak spots. 

HESI Prep Courses & Practice Tests

HESI offers its own “assignable and gradable” quizzes for self-practice. Self-quizzing throughout your nursing program will best prepare you for answering questions on your licensure exam. It also provides you with details into the subject areas you are underperforming in. 

Several other companies also offer HESI prep courses online. Some of the most popular courses include:

  1. Mometrics
  2. Nursing.com*
  3. Pocket Prep

Prep courses are an excellent way to prepare yourself for the NCLEX throughout your program. You can also focus your energy on taking practice tests that align with the coursework you are currently studying.

Prep courses allow you to answer thousands of potential test questions in the same topics you will be tested on during HESI and NCLEX exams.

What to Do After the HESI Exam

How Long Does it Take to Get Results?

You will receive your HESI score shortly after your exam. Your score and a remediation plan are sent to you within two weeks of completing the exam. 

What Happens if You Fail the HESI Exam? 

The HESI exam is not a traditional pass/fail exam. It gives you a numerical score between 100-1000. The higher the number, the better you performed on the exam. 

Your nursing institution may have a score that you must meet for program acceptance. You need to speak with your administrators to see what the minimum accepted score is. 

Most nursing schools require that students take the HESI before graduation to ensure they are ready to take the NCLEX. Many nursing programs require a score of 850 or higher because that indicates you will most likely pass the NCLEX.

If your score is too low, you will need to retake the exam. Before you do, make sure that you study with HESI prep courses that will help you perform better the next time. 

No matter what nursing program you go to, you will need to study to pass your courses and licensure exams. The HESI exams are a great tool to ensure that you have the necessary knowledge to earn licensure and perform as a nurse. The testing may seem daunting, but you will succeed if you study hard, focus, and use preparation courses.

Sarah Jividen
Sarah Jividen
Nurse.org Contributor

Sarah Jividen, RN, BSN, is a trained neuro/trauma and emergency room nurse turned freelance healthcare writer/editor. As a journalism major, she combined her love for writing with her passion for high-level patient care. Sarah is the creator of Health Writing Solutions, LLC, specializing in writing about healthcare topics, including health journalism, education, and evidence-based health and wellness trends. She lives in Northern California with her husband and two children. 

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