TEAS vs. HESI A2: Which Nursing Entrance Exam Do You Need?

Two Exams, One Decision

Nursing applicants often discover late that there are two major entrance exams — the ATI TEAS 7 and the Elsevier HESI A2 — and that programs typically require one or the other, rarely both. Studying for the wrong one wastes weeks and can force an expensive retest against an application deadline. About 70 to 80 percent of nursing programs use the TEAS, with most of the remainder using the HESI A2, so the odds favor the TEAS — but odds are not a plan.

This guide compares the two exams head to head on format, content, cost, scoring, and difficulty, then gives you a simple decision process so you prepare for the right test with confidence.

Head-to-Head Comparison

Feature	ATI TEAS 7	HESI A2
Publisher	ATI Nursing Education	Elsevier
Questions	170 fixed	Up to 326, varies by school
Sections	4 fixed: Reading, Math, Science, English	Up to 8 chosen by the school
Testing time	209 minutes (3h 29m)	Varies by sections assigned
Program usage	About 70–80% of programs	About 20–30% of programs
Typical cost	About $120 via ATI or PSI	Varies by institution
Scheduling	Year-round via ATI, PSI, or schools	Arranged through the school

Content: Fixed vs. Custom

The TEAS is identical everywhere: Reading (45 questions), Math (38), Science (50), and English and Language Usage (37), always in that order, always 209 minutes. That uniformity makes preparation straightforward — one blueprint, one set of materials.

The HESI A2 is modular: each school selects which of up to 8 sections applicants take, commonly Mathematics, Reading Comprehension, Vocabulary, Grammar, Biology, Chemistry, and Anatomy and Physiology. Two students taking the "same" HESI at different schools can sit substantially different exams — which means HESI preparation must start with your school's specific section list, not a generic guide.

Scoring, Difficulty, and Retakes

Neither exam has a universal passing score; each program sets its own cutoffs, and both report section-level detail schools may weigh individually (Science is the frequent gatekeeper on both). The TEAS reports a composite percentage plus proficiency levels from Developmental to Exemplary; the HESI reports percentage scores per section that schools often convert to their own scales.

On difficulty, the exams stress different skills. The TEAS challenges with breadth under time pressure — 170 questions across four timed sections with alternate formats like select-all-that-apply. The HESI challenges with depth and length — more questions overall, plus vocabulary and grammar sections the TEAS folds into English. Retake rules for both are set by schools and the testing route, commonly involving wait periods and yearly attempt caps, so confirm policy before scheduling either.

How to Decide in Three Steps

1. Check every target program's admissions page. This single step decides the matter in most cases — programs name their required exam explicitly. Never assume; a school can switch exams between cycles.
2. If programs split, follow the majority. When most of your schools want the TEAS, prepare for the TEAS; adding a second exam doubles cost, study time, and deadline risk.
3. If one dream school differs, ask about flexibility. A few programs accept either exam or grant exceptions — a short email to admissions can save you a second full preparation cycle.

Study Strategy for Each Exam

• TEAS: one fixed blueprint rewards one structured plan — diagnose with a full timed test, repair Science first, then Math, then Reading and English.
• HESI: get the school's section list in writing first, then prepare only those sections — vocabulary and A&P depth matter more here.
• Both: timed practice under real conditions, a miss log naming the exact error, and score targets taken from your programs rather than national averages.

The TEAS-versus-HESI question has a boring correct answer: take the test your schools require. Confirm it in writing, prepare for that exam only, and put the decision behind you so every study hour moves your actual application forward.