THE HESI A2 TUTOR'S TEACHING
GUIDE
A Complete Section-by-Section Manual with
Lessons, Worked Examples & Practice Questions
Prepared for HESI tutoring — covers all 8 scored sections of the Elsevier Admission
Assessment (A2) exam
HOW TO USE THIS GUIDE
This guide is written for the tutor, not the student. Each section follows the same
pattern:
1. Section briefing — what the exam tests, how many questions, how much time,
and how questions are actually set.
2. Teach it — the full lesson content, organized the way you should teach it.
Explanations are written so you can read, paraphrase, or expand them in a
session.
3. Worked examples — problems solved step by step, showing the thinking you
want your student to copy.
4. Practice questions — exam-style multiple-choice items for drills and
homework.
5. Answer key with explanations — every answer explained, including why the
wrong choices are wrong. This is the most valuable part: teach from the
explanations.
A note on the questions in this guide: they are original questions written in the
style and difficulty of the HESI A2, based on widely reported topic patterns. They
are not copied from any prep book or from the real exam. Treat them as
representative drills.
PART 0 — THE EXAM ITSELF
What the HESI A2 Is
The HESI Admission Assessment (A2) is Elsevier's nursing-school entrance exam. It
is a modular battery: each school selects which sections its applicants must take,
and each section is separately timed. The full battery takes about four hours on a
computer.
The 8 Scored Sections
Section Questions Time What it covers
Fractions, decimals,
percentages, ratios,
Mathematics 55 50 min
conversions, word
problems
, Section Questions Time What it covers
Short passages;
main idea, details,
Reading
55 60 min inferences,
Comprehension
vocabulary in
context
Medical
Vocabulary & terminology +
55 50 min
General Knowledge general English
word meanings
Sentence
correctness,
agreement,
Grammar 55 50 min
punctuation,
commonly confused
words
Body systems,
Anatomy & terminology,
30 25 min
Physiology organ–function
pairs
Cells, genetics,
Biology 30 25 min respiration,
photosynthesis
Atomic structure,
Chemistry 30 25 min bonding, pH, basic
reactions
Motion, force,
Physics 30 25 min energy, electricity
basics
Each section also contains a small number of unscored pilot questions (around
5) mixed in — the student cannot tell which ones they are, so every question must
be treated as real.
Two additional sections are unscored: a Learning Style inventory (~14 questions)
and a Personality Profile (~15 questions). Some schools add an optional scored
Critical Thinking section. Tell your student: do not stress about the unscored
sections; answer honestly and move on.
Most schools require only a subset — very commonly Mathematics, Reading
Comprehension, Vocabulary, Grammar, and Anatomy & Physiology. Biology and
Chemistry are required less often; Physics is rare. The single most important
administrative step: confirm with the student's nursing program exactly
which sections are required, what score is needed (composite average vs.
per-section minimums), and the retake policy before building a study plan.
,How Questions Are Set
• Every scored academic section is four-option multiple choice. There are no
fill-in-the-blank or select-all-that-apply items (unlike the TEAS exam).
• Difficulty is basic to applied. The exam rarely asks for obscure facts; it rewards
solid fundamentals applied under time pressure.
• You cannot go back. Once an answer is submitted within a section, it is locked.
Teach your student to commit and move on.
• An on-screen calculator is provided for math. Personal calculators are not
allowed. Scratch paper is usually provided by the testing center.
• No periodic table is provided in the chemistry section — basic atomic facts
must be memorized.
• The clock keeps running during breaks. At many centers the student may
choose the order of sections — advise doing the hardest required sections first,
before fatigue sets in.
How the Exam Is Scored
• Scores are reported as percentages per section, usually visible immediately
after each section.
• There is no national passing score. Each program sets its own bar — typically
75–80% per section or as a composite average; competitive BSN programs may
require 80–85%.
• Two scoring models exist:
• Composite/average model: section scores are averaged; a strong section can
carry a weak one.
• Per-section minimum model: every required section must clear the bar (e.g.,
75% on each); one failing section sinks the application.
• Retakes usually require a waiting period (commonly 60 days) with a limited
number of attempts per year (commonly 2–3). A retake means sitting the entire
required battery again — sections cannot be retaken individually. Schools
differ on whether they use the highest composite, the highest per-section scores
("superscoring"), the most recent attempt, or an average.
• Scores are generally valid 1–2 years.
Test-Taker Consensus on Difficulty (Hardest → Easiest)
1. Anatomy & Physiology — broad content, only 25 scored questions, so each
miss costs about 4 percentage points.
2. Chemistry (when required) — many students score lowest here.
3. Mathematics — procedural and predictable, but conversions are make-or-break
under time pressure.
4. Reading Comprehension — passages are easy; the answer choices are close.
5. Biology — basic cell and genetics material.
6. Vocabulary / Grammar — most approachable, though grammar's "choose the
incorrect sentence" format punishes rushing.
General Test-Taking Strategy (Teach This First)
1. Confirm the rules of the game. Required sections, target scores, retake
policy — before opening a book.
2. Take a timed diagnostic on the required sections only. Tag every miss by
topic; the pattern of misses becomes the study plan.
3. Conversions first. The math conversion tables are pure memorization and
, worth "free points."
4. Never sink minutes into one brutal question. It may be an unscored pilot
item. Mark your best guess and move on.
5. Process of elimination. On science sections, eliminate the obviously wrong
choices first; the remaining two can usually be separated by one key fact.
6. Trust the first instinct on vocabulary; overthinking changes right answers to
wrong ones.
7. Read grammar items slowly. Misspellings and agreement errors are designed
to survive a fast read.
Chapter 1: Mathematics
Section Briefing
The HESI A2 Mathematics section has 55 questions (50 scored) and a
50-minute time limit — under one minute per question. An on-screen
calculator is provided, so raw arithmetic speed matters less than setup:
test-takers consistently report that the arithmetic is easy and the points are won or
lost on choosing the right conversion factor and setting up the proportion
correctly. Difficulty is basic through roughly eighth-grade math: fractions,
decimals, percentages, ratios, word problems, and measurement conversions.
There are no multiple-choice tricks hiding behind advanced concepts — the trap is
almost always a wrong unit.
Teach the section in this priority order: (1) the conversion tables (pure
memorization — flashcard these first, because they are "free points"); (2) ratios
and proportions, which are the engine of every dosage-style word problem; (3)
fraction/decimal/percent fluency; (4) the smaller specialty topics (military time,
Roman numerals, algebra, statistics basics).
Teach It
Measurement Conversions
This is the highest-yield material in the whole section. Students should be able to
do these conversions instantly, without working them out.
Metric prefixes — the metric system is decimal, so every conversion is a move of
the decimal point:
Unit Equals
1 liter (L) 1,000 milliliters (mL)
1 gram (g) 1,000 milligrams (mg)
1 milligram (mg) 1,000 micrograms (mcg)
100 centimeters (cm) = 1,000
1 meter (m)
millimeters (mm)
1 kilometer (km) 1,000 meters
The ladder from largest to smallest: kilo → (base) → centi → milli → micro. Moving
down the ladder (large to small) multiplies by 1,000 per step; moving up divides by
GUIDE
A Complete Section-by-Section Manual with
Lessons, Worked Examples & Practice Questions
Prepared for HESI tutoring — covers all 8 scored sections of the Elsevier Admission
Assessment (A2) exam
HOW TO USE THIS GUIDE
This guide is written for the tutor, not the student. Each section follows the same
pattern:
1. Section briefing — what the exam tests, how many questions, how much time,
and how questions are actually set.
2. Teach it — the full lesson content, organized the way you should teach it.
Explanations are written so you can read, paraphrase, or expand them in a
session.
3. Worked examples — problems solved step by step, showing the thinking you
want your student to copy.
4. Practice questions — exam-style multiple-choice items for drills and
homework.
5. Answer key with explanations — every answer explained, including why the
wrong choices are wrong. This is the most valuable part: teach from the
explanations.
A note on the questions in this guide: they are original questions written in the
style and difficulty of the HESI A2, based on widely reported topic patterns. They
are not copied from any prep book or from the real exam. Treat them as
representative drills.
PART 0 — THE EXAM ITSELF
What the HESI A2 Is
The HESI Admission Assessment (A2) is Elsevier's nursing-school entrance exam. It
is a modular battery: each school selects which sections its applicants must take,
and each section is separately timed. The full battery takes about four hours on a
computer.
The 8 Scored Sections
Section Questions Time What it covers
Fractions, decimals,
percentages, ratios,
Mathematics 55 50 min
conversions, word
problems
, Section Questions Time What it covers
Short passages;
main idea, details,
Reading
55 60 min inferences,
Comprehension
vocabulary in
context
Medical
Vocabulary & terminology +
55 50 min
General Knowledge general English
word meanings
Sentence
correctness,
agreement,
Grammar 55 50 min
punctuation,
commonly confused
words
Body systems,
Anatomy & terminology,
30 25 min
Physiology organ–function
pairs
Cells, genetics,
Biology 30 25 min respiration,
photosynthesis
Atomic structure,
Chemistry 30 25 min bonding, pH, basic
reactions
Motion, force,
Physics 30 25 min energy, electricity
basics
Each section also contains a small number of unscored pilot questions (around
5) mixed in — the student cannot tell which ones they are, so every question must
be treated as real.
Two additional sections are unscored: a Learning Style inventory (~14 questions)
and a Personality Profile (~15 questions). Some schools add an optional scored
Critical Thinking section. Tell your student: do not stress about the unscored
sections; answer honestly and move on.
Most schools require only a subset — very commonly Mathematics, Reading
Comprehension, Vocabulary, Grammar, and Anatomy & Physiology. Biology and
Chemistry are required less often; Physics is rare. The single most important
administrative step: confirm with the student's nursing program exactly
which sections are required, what score is needed (composite average vs.
per-section minimums), and the retake policy before building a study plan.
,How Questions Are Set
• Every scored academic section is four-option multiple choice. There are no
fill-in-the-blank or select-all-that-apply items (unlike the TEAS exam).
• Difficulty is basic to applied. The exam rarely asks for obscure facts; it rewards
solid fundamentals applied under time pressure.
• You cannot go back. Once an answer is submitted within a section, it is locked.
Teach your student to commit and move on.
• An on-screen calculator is provided for math. Personal calculators are not
allowed. Scratch paper is usually provided by the testing center.
• No periodic table is provided in the chemistry section — basic atomic facts
must be memorized.
• The clock keeps running during breaks. At many centers the student may
choose the order of sections — advise doing the hardest required sections first,
before fatigue sets in.
How the Exam Is Scored
• Scores are reported as percentages per section, usually visible immediately
after each section.
• There is no national passing score. Each program sets its own bar — typically
75–80% per section or as a composite average; competitive BSN programs may
require 80–85%.
• Two scoring models exist:
• Composite/average model: section scores are averaged; a strong section can
carry a weak one.
• Per-section minimum model: every required section must clear the bar (e.g.,
75% on each); one failing section sinks the application.
• Retakes usually require a waiting period (commonly 60 days) with a limited
number of attempts per year (commonly 2–3). A retake means sitting the entire
required battery again — sections cannot be retaken individually. Schools
differ on whether they use the highest composite, the highest per-section scores
("superscoring"), the most recent attempt, or an average.
• Scores are generally valid 1–2 years.
Test-Taker Consensus on Difficulty (Hardest → Easiest)
1. Anatomy & Physiology — broad content, only 25 scored questions, so each
miss costs about 4 percentage points.
2. Chemistry (when required) — many students score lowest here.
3. Mathematics — procedural and predictable, but conversions are make-or-break
under time pressure.
4. Reading Comprehension — passages are easy; the answer choices are close.
5. Biology — basic cell and genetics material.
6. Vocabulary / Grammar — most approachable, though grammar's "choose the
incorrect sentence" format punishes rushing.
General Test-Taking Strategy (Teach This First)
1. Confirm the rules of the game. Required sections, target scores, retake
policy — before opening a book.
2. Take a timed diagnostic on the required sections only. Tag every miss by
topic; the pattern of misses becomes the study plan.
3. Conversions first. The math conversion tables are pure memorization and
, worth "free points."
4. Never sink minutes into one brutal question. It may be an unscored pilot
item. Mark your best guess and move on.
5. Process of elimination. On science sections, eliminate the obviously wrong
choices first; the remaining two can usually be separated by one key fact.
6. Trust the first instinct on vocabulary; overthinking changes right answers to
wrong ones.
7. Read grammar items slowly. Misspellings and agreement errors are designed
to survive a fast read.
Chapter 1: Mathematics
Section Briefing
The HESI A2 Mathematics section has 55 questions (50 scored) and a
50-minute time limit — under one minute per question. An on-screen
calculator is provided, so raw arithmetic speed matters less than setup:
test-takers consistently report that the arithmetic is easy and the points are won or
lost on choosing the right conversion factor and setting up the proportion
correctly. Difficulty is basic through roughly eighth-grade math: fractions,
decimals, percentages, ratios, word problems, and measurement conversions.
There are no multiple-choice tricks hiding behind advanced concepts — the trap is
almost always a wrong unit.
Teach the section in this priority order: (1) the conversion tables (pure
memorization — flashcard these first, because they are "free points"); (2) ratios
and proportions, which are the engine of every dosage-style word problem; (3)
fraction/decimal/percent fluency; (4) the smaller specialty topics (military time,
Roman numerals, algebra, statistics basics).
Teach It
Measurement Conversions
This is the highest-yield material in the whole section. Students should be able to
do these conversions instantly, without working them out.
Metric prefixes — the metric system is decimal, so every conversion is a move of
the decimal point:
Unit Equals
1 liter (L) 1,000 milliliters (mL)
1 gram (g) 1,000 milligrams (mg)
1 milligram (mg) 1,000 micrograms (mcg)
100 centimeters (cm) = 1,000
1 meter (m)
millimeters (mm)
1 kilometer (km) 1,000 meters
The ladder from largest to smallest: kilo → (base) → centi → milli → micro. Moving
down the ladder (large to small) multiplies by 1,000 per step; moving up divides by
