HESI A2 Anatomy & Physiology – Nursing School Entrance Exam – Complete
Study Guide and Practice Questions with Correct Answers (2026)
Below is a comprehensive 30-question practice test covering all major systems tested on the HESI A2
exam. The questions are designed to reflect current exam trends, incorporating both foundational
knowledge and clinical application scenarios.
Cellular Biology & Tissues
1. Which cellular organelle is responsible for modifying, packaging, and shipping proteins to their final
destinations? A. Mitochondria B. Golgi apparatus C. Lysosome D. Rough endoplasmous reticulum
Correct Answer: B Explainer: The Golgi apparatus functions as the cell's "processing and shipping
center." It receives proteins from the rough ER, modifies them (such as adding carbohydrate groups),
packages them into vesicles, and directs them to their target locations inside or outside the cell.
2. During cellular respiration, in which phase is the majority of ATP produced? A. Glycolysis B. Krebs
cycle (Citric Acid Cycle) C. Electron transport chain and oxidative phosphorylation D. Fermentation
Correct Answer: C Explainer: While glycolysis and the Krebs cycle produce small amounts of ATP
directly, the electron transport chain and oxidative phosphorylation generate approximately 34 of the
36-38 ATP molecules per glucose molecule. This occurs as electrons are passed along protein complexes,
creating a proton gradient that drives ATP synthase.
3. A tissue sample shows cells arranged in multiple layers with flattened surface cells. This tissue is
most likely found in which location? A. Alveoli of the lungs B. Lining of the esophagus C. Inner lining of
the bladder D. Trachea Correct Answer: B Explainer: This describes stratified squamous epithelium,
which is designed for protection against abrasion. The esophagus is subjected to mechanical stress from
food passage and is lined by non-keratinized stratified squamous epithelium. The alveoli use simple
squamous epithelium for gas exchange, the bladder uses transitional epithelium for stretching, and the
trachea uses pseudostratified ciliated columnar epithelium.
4. Which type of connective tissue provides tensile strength in multiple directions and is found in the
dermis of the skin? A. Dense regular connective tissue B. Dense irregular connective tissue C. Areolar
connective tissue D. Reticular connective tissue Correct Answer: B Explainer: Dense irregular connective
tissue contains collagen fibers arranged in random, interwoven patterns that resist tension from various
angles. This makes it ideal for the dermis, which experiences multidirectional stress. Dense regular tissue
has parallel fibers for unidirectional strength (tendons/ligaments).
Integumentary System
, 5. A patient presents with yellowing skin and sclera. Which pigment accumulation is responsible for
this clinical manifestation? A. Melanin B. Carotene C. Bilirubin D. Hemosiderin Correct Answer: C
Explainer: Jaundice results from elevated bilirubin levels in the blood, which deposits in elastic tissues
like skin and sclera. Bilirubin is a yellow pigment produced from heme breakdown. While carotene can
cause yellowing (carotenemia), it spares the sclera. Melanin causes brown/black pigmentation, and
hemosiderin causes brownish discoloration from iron storage.
6. Which layer of the epidermis contains cells undergoing rapid mitotic division? A. Stratum corneum
B. Stratum lucidum C. Stratum granulosum D. Stratum basale (stratum germinativum) Correct Answer: D
Explainer: The stratum basale (also called stratum germinativum) is the deepest epidermal layer
attached to the basement membrane. It contains stem cells and keratinocytes that continuously divide
by mitosis, pushing older cells superficially. This layer also contains melanocytes and Merkel cells.
7. Which skin structure is responsible for thermoregulation through evaporative cooling? A. Sebaceous
glands B. Eccrine sweat glands C. Apocrine sweat glands D. Arrector pili muscles Correct Answer: B
Explainer: Eccrine sweat glands are distributed over most of the body surface and produce watery sweat
for thermoregulation. When sweat evaporates from the skin surface, it removes heat. While apocrine
glands produce sweat, they are limited to specific areas and function primarily in scent communication,
not cooling.
Skeletal System
8. Which bone classification describes the patella? A. Long bone B. Short bone C. Flat bone D. Sesamoid
bone Correct Answer: D Explainer: The patella is the largest sesamoid bone—a bone that forms within a
tendon. Sesamoid bones protect tendons from excessive wear and improve mechanical leverage. The
patella specifically protects the knee joint and increases the leverage of the quadriceps tendon.
9. A fracture where the bone breaks cleanly but does not penetrate the skin is classified as: A.
Compound (open) fracture B. Simple (closed) transverse fracture C. Comminuted fracture D. Greenstick
fracture Correct Answer: B Explainer: A simple (closed) fracture does not break the skin, while a
compound (open) fracture does. A transverse fracture has a break perpendicular to the bone's long axis.
This describes a clean break without skin penetration—distinct from comminuted (multiple fragments)
or greenstick (incomplete, bending break common in children).
10. Which cells are responsible for bone resorption during remodeling? A. Osteoblasts B. Osteocytes C.
Osteoclasts D. Chondroblasts Correct Answer: C Explainer: Osteoclasts are large, multinucleated cells
that secrete hydrochloric acid and enzymes to dissolve bone mineral and matrix, a process called
resorption. This is essential for calcium homeostasis and bone remodeling. Osteoblasts build bone,
osteocytes maintain it, and chondroblasts produce cartilage.
Study Guide and Practice Questions with Correct Answers (2026)
Below is a comprehensive 30-question practice test covering all major systems tested on the HESI A2
exam. The questions are designed to reflect current exam trends, incorporating both foundational
knowledge and clinical application scenarios.
Cellular Biology & Tissues
1. Which cellular organelle is responsible for modifying, packaging, and shipping proteins to their final
destinations? A. Mitochondria B. Golgi apparatus C. Lysosome D. Rough endoplasmous reticulum
Correct Answer: B Explainer: The Golgi apparatus functions as the cell's "processing and shipping
center." It receives proteins from the rough ER, modifies them (such as adding carbohydrate groups),
packages them into vesicles, and directs them to their target locations inside or outside the cell.
2. During cellular respiration, in which phase is the majority of ATP produced? A. Glycolysis B. Krebs
cycle (Citric Acid Cycle) C. Electron transport chain and oxidative phosphorylation D. Fermentation
Correct Answer: C Explainer: While glycolysis and the Krebs cycle produce small amounts of ATP
directly, the electron transport chain and oxidative phosphorylation generate approximately 34 of the
36-38 ATP molecules per glucose molecule. This occurs as electrons are passed along protein complexes,
creating a proton gradient that drives ATP synthase.
3. A tissue sample shows cells arranged in multiple layers with flattened surface cells. This tissue is
most likely found in which location? A. Alveoli of the lungs B. Lining of the esophagus C. Inner lining of
the bladder D. Trachea Correct Answer: B Explainer: This describes stratified squamous epithelium,
which is designed for protection against abrasion. The esophagus is subjected to mechanical stress from
food passage and is lined by non-keratinized stratified squamous epithelium. The alveoli use simple
squamous epithelium for gas exchange, the bladder uses transitional epithelium for stretching, and the
trachea uses pseudostratified ciliated columnar epithelium.
4. Which type of connective tissue provides tensile strength in multiple directions and is found in the
dermis of the skin? A. Dense regular connective tissue B. Dense irregular connective tissue C. Areolar
connective tissue D. Reticular connective tissue Correct Answer: B Explainer: Dense irregular connective
tissue contains collagen fibers arranged in random, interwoven patterns that resist tension from various
angles. This makes it ideal for the dermis, which experiences multidirectional stress. Dense regular tissue
has parallel fibers for unidirectional strength (tendons/ligaments).
Integumentary System
, 5. A patient presents with yellowing skin and sclera. Which pigment accumulation is responsible for
this clinical manifestation? A. Melanin B. Carotene C. Bilirubin D. Hemosiderin Correct Answer: C
Explainer: Jaundice results from elevated bilirubin levels in the blood, which deposits in elastic tissues
like skin and sclera. Bilirubin is a yellow pigment produced from heme breakdown. While carotene can
cause yellowing (carotenemia), it spares the sclera. Melanin causes brown/black pigmentation, and
hemosiderin causes brownish discoloration from iron storage.
6. Which layer of the epidermis contains cells undergoing rapid mitotic division? A. Stratum corneum
B. Stratum lucidum C. Stratum granulosum D. Stratum basale (stratum germinativum) Correct Answer: D
Explainer: The stratum basale (also called stratum germinativum) is the deepest epidermal layer
attached to the basement membrane. It contains stem cells and keratinocytes that continuously divide
by mitosis, pushing older cells superficially. This layer also contains melanocytes and Merkel cells.
7. Which skin structure is responsible for thermoregulation through evaporative cooling? A. Sebaceous
glands B. Eccrine sweat glands C. Apocrine sweat glands D. Arrector pili muscles Correct Answer: B
Explainer: Eccrine sweat glands are distributed over most of the body surface and produce watery sweat
for thermoregulation. When sweat evaporates from the skin surface, it removes heat. While apocrine
glands produce sweat, they are limited to specific areas and function primarily in scent communication,
not cooling.
Skeletal System
8. Which bone classification describes the patella? A. Long bone B. Short bone C. Flat bone D. Sesamoid
bone Correct Answer: D Explainer: The patella is the largest sesamoid bone—a bone that forms within a
tendon. Sesamoid bones protect tendons from excessive wear and improve mechanical leverage. The
patella specifically protects the knee joint and increases the leverage of the quadriceps tendon.
9. A fracture where the bone breaks cleanly but does not penetrate the skin is classified as: A.
Compound (open) fracture B. Simple (closed) transverse fracture C. Comminuted fracture D. Greenstick
fracture Correct Answer: B Explainer: A simple (closed) fracture does not break the skin, while a
compound (open) fracture does. A transverse fracture has a break perpendicular to the bone's long axis.
This describes a clean break without skin penetration—distinct from comminuted (multiple fragments)
or greenstick (incomplete, bending break common in children).
10. Which cells are responsible for bone resorption during remodeling? A. Osteoblasts B. Osteocytes C.
Osteoclasts D. Chondroblasts Correct Answer: C Explainer: Osteoclasts are large, multinucleated cells
that secrete hydrochloric acid and enzymes to dissolve bone mineral and matrix, a process called
resorption. This is essential for calcium homeostasis and bone remodeling. Osteoblasts build bone,
osteocytes maintain it, and chondroblasts produce cartilage.
