Step 1: find out what your program actually requires
The HESI A2 is not one fixed test. Elsevier's 2022 white paper says programs "can elect to administer all seven A2 exams or customize the number of exams". In the current platform the program picks the sections when it schedules the exam, and the estimated time "can be adjusted manually" (Elsevier Faculty Guide). The same guide shows that the program also switches the on-screen calculator on or off.
So before you buy anything or build a schedule, get these four answers from the program's admissions page or office:
- Which exams you take (all seven, or a subset such as math, reading and one science).
- Which score counts: the composite, a minimum per exam, or both.
- Calculator allowed or not.
- Retake rules: how soon, how often, and whether the best or latest score is used.
Everything below assumes you know your list. The number of items and minutes per exam are on our HESI A2 practice test page; this guide is about how to study for them.
Step 2: take a diagnostic and rank your sections
Elsevier's own review book opens with a diagnostic: the 6th edition starts with a 25-question pre-test and ends with a 50-question post-test, both with rationales. Whatever you use, start with a short timed test in each exam on your list and sort the sections into three piles: weak, average, strong. Spend roughly half your study time on the weak pile.
One fact from Elsevier helps you set priorities: each exam gets its own score, and the composite score is calculated "by averaging the results of all exams completed" (white paper). A science exam has 25 scored items and an English exam 50, but each counts as one exam in that average, so do not neglect a science exam because it looks small.
Step 3: study each section with the right method
The topic lists below are Elsevier's own descriptions from its exam overview; the methods are our advice.
Basic Math Skills
Elsevier lists addition, subtraction, multiplication, fractions, decimals, ratio and proportion, household measures and general math facts. In practice most items are arithmetic done carefully.
- Drill fraction, decimal and percent conversions until you do them without thinking.
- Set up every word problem as a proportion. Dosage-style questions are proportions with units.
- Learn the household measures and conversions as a table, then test yourself on it daily.
- If your program disables the calculator, practice everything by hand from day one.
Free questions: HESI A2 math practice.
Reading Comprehension
Elsevier describes reading scenarios (health-related, according to the 2022 white paper) in which you identify the main idea, find the meaning of words in context, understand the passage and make logical inferences.
- After each passage, write the main idea in one sentence before looking at the questions.
- For every answer, point to the line that supports it. If you cannot, it is probably a distractor.
- Time yourself: reading is where candidates run out of time without noticing.
Free questions: HESI A2 reading practice.
Vocabulary and General Knowledge
Elsevier's description is vocabulary used in everyday English and in health care. This is the section where a little every day beats cramming.
- Keep a running list of health-care words you meet (in the review book, in your science reading) and review it with flashcards.
- Learn common prefixes, roots and suffixes: they let you work out words you have never seen.
Free questions: HESI A2 vocabulary practice.
Grammar
Elsevier lists parts of speech, important grammar terms and their uses, and commonly occurring grammatical errors.
- Study error types one at a time: subject-verb agreement, pronoun case, verb tense, commonly confused words, punctuation.
- For each practice error, write down the rule it broke. The same few rules come back again and again.
Free questions: HESI A2 grammar practice.
Biology, Chemistry, Anatomy and Physiology
Elsevier's topic lists are: for Biology, biology basics, water, biological molecules, metabolism, cells, cellular respiration and photosynthesis; for Chemistry, matter, chemical equations and reactions, the periodic table, atomic structure, nuclear chemistry and chemical bonding; for Anatomy and Physiology, general terminology and anatomical structures and systems (overview).
- Study only the science exams on your list.
- For A&P, go system by system: structures, what they do, and the terms that describe position and direction.
- For chemistry, make sure you can balance a simple equation and read the periodic table before anything else.
- The free OpenStax textbooks (Anatomy and Physiology 2e, Biology 2e, Chemistry 2e) are good references when a review book explanation is too short. Use their chapter summaries, not the whole book.
Free questions: anatomy and physiology, biology, chemistry.
The official review book: which edition?
Elsevier publishes the Admission Assessment Exam Review. The current 6th edition (ISBN 9780443114090) was published on March 26, 2024. According to Elsevier's page, it has chapters on mathematics, reading comprehension, vocabulary, grammar, biology, chemistry and anatomy and physiology, the 25-question pre-test and 50-question post-test, "HESI Hints" boxes, step-by-step math explanations, and more than 200 practice exam questions on its companion Evolve website.
The 5th edition (published in 2020) has one more chapter: Physics. The 6th edition drops it. If your program lists physics, a used 5th edition is the only Elsevier review of that topic we could find; if it does not, the 6th edition is the one to get.
Elsevier's white paper also calls the review book "a useful resource for applicants to prepare for the A2 or improve their scores" (white paper). It is a paid book.
A sample schedule
There is no official study length. This is a sample plan for about six weeks at an hour a day, assuming you take four or more exams; compress or stretch it to your deadline.
| Week | Focus |
|---|---|
| 1 | Get the program's list. Timed diagnostic in each required exam. Start a daily vocabulary list. |
| 2 | Math: conversions, fractions, percentages, proportions. Grammar: two error types per day. |
| 3 | Weakest science exam, system by system or topic by topic. Reading: one timed passage per day. |
| 4 | Second science exam (if required). Math word problems under time. |
| 5 | Mixed timed sets in every required exam. Rework every mistake and write down why. |
| 6 | One or two full timed runs with your program's section list. Light review the day before. |
If you need to retake
Programs schedule a separate exam version for first-time and second-time testers (Faculty Guide), so expect different questions on a retake. Your results report is in your HESI NG course, reached through your Evolve account (Evolve Support). The program can also switch on remediation packets with personalized study content for every concept where you scored below a benchmark it sets (Faculty Guide), and Elsevier suggests using remediation content before repeat testing (white paper). Start your second plan from the weak areas in your report and in any packets you receive.
Where to practice
Our free HESI A2 practice questions are original, written from Elsevier's published exam descriptions, with an explanation for every answer. They are not Elsevier material and cannot predict your score; use them to find weak areas and to get used to the timing.
Sources
- 2022 Scientific Evidence for the HESI Admission Assessment (A2), white paper — Elsevier (checked September 30, 2026)
- HESI Admission Assessment Exam overview sheet (2015) — Elsevier, copy hosted by Georgia Southwestern State University (checked September 30, 2026)
- Admission Assessment Exam Review, 6th Edition — Elsevier (checked September 30, 2026)
- Admission Assessment Exam Review, 5th Edition — Elsevier (checked September 30, 2026)
- HESI A2 Exam Process Faculty Guide (HESI NG) — Elsevier (checked September 30, 2026)
- Where can I find my HESI exam scoring information? — Evolve Support Center, Elsevier (checked September 30, 2026)
- Anatomy and Physiology 2e, Biology 2e, Chemistry 2e — OpenStax (Rice University) (checked September 30, 2026)
HESI and HESI A2 are trademarks of Elsevier, which is not affiliated with and does not endorse passmock.
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