Overview of the HESI Nursing School Entrance and Exit Exams

Female student studying at the library.

What Aspiring RNs Need to Know About Entrance and Exit Testing

The Health Education Systems Incorporated (HESI) exams are tests you may take at the beginning and end of your nursing education. There are two exams: The HESI A2, which is a nursing school entrance exam used by many schools to identify qualified candidates; and the HESI Exit Exam, which many nurses take at the end of their nursing program to measure preparedness for the NCLEX-RN (National Council Licensure Exam).

Neither exam is nationally mandated, but both HESI exams are commonly used, and many nursing schools require the HESI A2 as part of your application.

Here we provide an overview and breakdown of both HESI exams, including everything you need to know about HESI exam registration, a breakdown of HESI exam questions and topics, and how your results relate to the next steps in your nursing education and career.

The HESI A2 Entrance Exam

The HESI A2 entrance exam is used by most nursing schools to assess prospective students for admission. Nursing programs administer this test themselves, and often will tailor the test according to which specific areas they want to assess. Schools also have their own scoring requirements for entry. Depending on your school of choice, the test itself and passing requirements will vary.

What’s on the Exam?

The full HESI A2 generally takes over six hours to complete, but again, your test contents, timing, and scoring will depend on the school administering the test. Questions cover language skills and general knowledge, science and math, and learning and personality. You may not be tested on all the questions provided in the comprehensive HESI A2; the test will include any combination of the following sections and questions:1

  • Reading comprehension (55 questions/60 minutes)
  • Vocabulary and general knowledge (55 questions/50 minutes)
  • Grammar (55 questions/50 minutes)
  • Basic math (55 questions/50 minutes)
  • Biology (30 questions/25 minutes)
  • Chemistry (30 questions/25 minutes)
  • Anatomy and physiology (30 questions/25 minutes)
  • Physics (25 questions/50 minutes)
  • Learning style (14 questions/15 minutes)
  • Personality profile (15 questions/15 minutes)

Most, but not all, nursing schools will require you to take some version of the HESI A2 as part of your application process. Check with the schools you’re applying to in order to determine whether the test is required and what will be included, so you can prepare accordingly.

Steps to Taking the HESI A2

You can, and should, begin preparing for the HESI A2 as early as you can. The cost to take the test can range from $25-$110,1 including proctor fees, with the cost being set by the school administering the test. Payment must take place before you register and is usually paid directly to the school.

  1. Contact the nursing school for requirements and their department ID number.
  2. Follow the school’s instructions to confirm testing eligibility through Elsevier Evolve.
  3. Receive an email confirming your eligibility with registration instructions.
  4. Register for your HESI A2 test date and location.
  5. Prepare for the test with study and practice materials.
  6. Arrive at the test center 30 minutes early to check in with a government-issued photo ID (e.g., license or passport).
  7. Complete your test within the allotted time.
  8. Your HESI A2 results will appear on-screen at the end of your exam.

After you take your test and get your results, you can decide whether to retake the exam. (You may retake the test after 60 days.) More comprehensive results, along with details on what you can focus on in preparation for the next round, can be found on the Elsevier site within two weeks. You can also request transcripts, if you’d like to send your test results to additional schools.

The HESI Exit Exam

The HESI Exit Exam is a test you may take at the end of your nursing program, to assess your readiness for the NCLEX-RN and further prepare you for it. This test is shorter than the HESI A2 entrance exam and designed to mirror the subjects that will be tested on the NCLEX-RN.

You aren’t required to take the HESI exit exam or similar exit exams for licensure, but it’s a very common component to the completion of nursing programs, and it can help you identify areas where you might need additional study to pass your licensure exam.

What’s on the Exam?

The HESI exit exam is designed around the NCLEX-RN test, so the topics covered will be largely similar. Like the HESI A2, this test can cost between $40-$100. You will be tested on three primary areas of competency: nursing process, client needs, and specialties. Each of these areas is broken down further below:2

Nursing Process

  • Assessment
  • 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 therapies


  • Nursing fundamentals
  • Geriatrics
  • OB-GYN
  • Medical-surgical
  • Pediatrics
  • Critical care
  • Community health
  • Mental health

TThe format of the test is similar to the HESI A2 exam, but it consists of only 150 questions.3 Consider the HESI exam your dress rehearsal for the NCLEX-RN. If you score well on your HESI exit test, you’re likely to perform well on your licensure exam as well.

Many nursing schools also implement HESI test materials throughout your program to help you gradually prepare for both your exit and licensure exams.

Are There Alternatives to the HESI Exam?

If you’re applying to nursing school, you should be aware that some programs may require a entrance or exit exam other than the HESI. For example, at West Coast University, we use the HESI entrance exam for students coming into our Bachelor to Science in Nursing program (BSN program), but we use a different test provider, ATI, for our exit exam.

Be sure to research your nursing program of interest and find out ahead of time which entrance and exit exams are required. Some schools may have a preference for one test provider but still allow students to use another provider upon request. (At WCU, we accept entrance exams other than the HESI for our BSN program.)


That’s natural. The best way to tame your nerves is to make sure you feel adequately prepared for the test. For tips on how to combat pre-test stress, visit our post on test anxiety.

Thinking ahead to the NCLEX-RN test? Read all about this mandatory nursing licensure exam in our NCLEX blog post.


1 https://nursingexams.org/hesi/registration-testing-and-locations/

2 https://nurse.org/resources/hesi-exam-guide/#hesi-a2-vs-hesi-exit-exam

3 https://nursingexams.org/hesi/passing-scores/

WCU provides career guidance and assistance but cannot guarantee employment. The views and opinions expressed are those of the individuals and do not necessarily reflect the beliefs or position of the school or of any instructor or student.