The ATI TEAS and HESI A2 are the two most common nursing school entrance exams – but they are not interchangeable, and most programs require one or the other, not both. Which exam you sit depends entirely on which programs you’re applying to. Before you spend a dollar on prep materials, confirm your target program’s requirements.
Quick answer:
- ATI TEAS is the more widely used of the two, required by the majority of ADN and BSN programs nationwide. It is produced by ATI Nursing Education.
- HESI A2 is required primarily by programs that partner with Elsevier, which publishes the exam. It is common in the South and Southeast, and at programs that use Elsevier’s clinical education products.
- Both exams test the same general content areas – math, science, reading, English – but differ in structure, scoring, and what individual programs require from each section.
Head-to-head comparison
| Feature | ATI TEAS 7 | HESI A2 |
|---|---|---|
| Publisher | ATI Nursing Education | Elsevier |
| Sections | 4 fixed (Science, Reading, Math, English) | Up to 8; programs choose which to require |
| Total questions | 170 (150 scored + 20 unscored pretest) | Varies by sections required |
| Score format | Composite % (Total Mean Score) | Composite % by section |
| Typical minimum score | 58–75% composite | 75–80% composite |
| Retake policy | 14 days at ATI-proctored centers; schools that administer it set their own interval, commonly 30 days | Set by the institution; commonly 30–60 days |
| Cost | $120 at ATI and PSI testing centers; institutions set their own price and may add proctor, room or remote-monitoring fees | Set entirely by the institution, not by Elsevier – commonly $45–$75, with published prices ranging from about $35 to $115, and remote proctoring often adding ~$25 |
| Testing location | ATI-approved testing center or remote proctored | Campus-based or remote proctored |
| Official prep materials | ATI TEAS practice tests (paid) | HESI Admission Assessment Exam Review (Elsevier) |
Which programs require which exam
There is no universal rule – programs choose which exam to accept. That said, patterns exist by region and program type:
Programs more likely to require the ATI TEAS:
- Community college ADN programs in the Northeast, Midwest, and West
- University BSN programs with pre-licensure tracks
- Accelerated BSN programs (ABSN)
- Programs affiliated with ATI’s clinical education platform
Programs more likely to require the HESI A2:
- Programs in Texas, Florida, and the Southeast
- Programs that already use Elsevier’s nursing textbooks and clinical resources
- Some associate degree programs in states where HESI has historical market share
Programs that accept either or both: Some schools give applicants the option. In those cases, choose the exam you feel better prepared for – they are not evaluated on a shared scale.
If you’re applying to multiple programs, check each program’s admissions page directly. Don’t assume because one school uses TEAS that all schools in your state do.
Section breakdown: ATI TEAS 7
The TEAS 7 has four mandatory sections, 170 questions and 209 minutes in total. Only 150 of those questions are scored – the other 20 are unscored pretest items ATI is trialling for future exams, and there is no way to tell which is which while you are sitting the test.
| Section | Scored questions | Total questions | Time | Key content |
|---|---|---|---|---|
| Science | 44 | 50 | 60 min | Human anatomy, physiology, biology, chemistry, scientific reasoning |
| Reading | 39 | 45 | 55 min | Passage comprehension, inference, text structure |
| Mathematics | 34 | 38 | 57 min | Numbers and algebra, measurement, data interpretation |
| English and Language Usage | 33 | 37 | 37 min | Grammar, vocabulary, punctuation |
Science carries the most weight by question count and tends to be the most difficult section for applicants without recent biology or chemistry coursework. For detailed preparation strategies by section, see the TEAS preparation guide.
Section breakdown: HESI A2
The HESI A2 is more modular. Programs specify which sections they require, so the time commitment and content coverage varies by school.
Like the TEAS, the HESI A2 embeds unscored trial items, and section sizes are quoted both ways in the wild. A 55-item section contains 50 scored questions and 5 unscored; a 30-item section contains 25 scored and 5 unscored. The scored counts are what your percentage is calculated from.
| Section | Scored questions | Items administered | Key content | Notes |
|---|---|---|---|---|
| Mathematics | 50 | 55 | Arithmetic, fractions, ratios, dosage | Required by most programs |
| Reading Comprehension | 47 | 55 | Main idea, inference, author purpose | Required by most programs |
| Vocabulary and General Knowledge | 50 | 55 | Medical and general vocabulary | Commonly required |
| Grammar | 50 | 55 | Parts of speech, sentence structure | Commonly required |
| Biology | 25 | 30 | Cell biology, genetics, metabolism | Required selectively |
| Chemistry | 25 | 30 | Atomic structure, reactions, acids/bases | Required selectively |
| Anatomy and Physiology | 25 | 30 | Body systems, organ function | Required selectively |
| Physics | 25 | 30 | Motion, force, energy | Rarely required |
Unlike the TEAS, you don’t take sections your program doesn’t require. Confirm with your admissions office which sections you need before purchasing prep materials. The HESI exam guide covers all section content in detail.
Scoring: what’s different
Both exams report percentage scores by section and a composite, but they mean different things.
ATI TEAS scoring: Your score is reported as a Total Mean Score (composite %) plus individual section percentages. Many programs set a minimum composite – commonly 58% for community college ADN programs and 65–75% for university BSN programs. Some programs also set section-specific minimums (often 50% per section minimum). Program average scores for accepted applicants typically range from 68% to 78%.
HESI A2 scoring: Each section is reported as a percentage from 0% to 100%, and your cumulative score is the average across the sections you sat. Elsevier does not publish a universal passing score – each program sets its own cutoff, and 75% cumulative is the common expectation for RN programs (70% is more typical for LPN/LVN programs). Some programs additionally set per-section minimums, which can differ section by section. Because programs choose different sections, comparing HESI scores across schools is less straightforward than TEAS. Some programs weight certain sections (particularly math and vocabulary) more heavily.
Note that the scoring is not a simple percentage of questions answered correctly: HESI uses a proprietary weighted model that factors in question difficulty. A common point of confusion is the 0–1500 scaled score with an 850 benchmark – that belongs to the HESI Exit Exam taken near the end of a nursing program as an NCLEX-readiness predictor, and it has nothing to do with A2 admission scoring.
How to prepare for each exam
Preparing for the ATI TEAS
- Take an ATI official practice test first. ATI sells two online practice tests for ~$30 each. These give the most accurate preview of the real exam’s difficulty and format.
- Focus on science and math. These sections are the most improvable and the highest leverage. If you haven’t taken biology or chemistry recently, budget time to review.
- Use ATI’s official study manual. Third-party TEAS prep books exist, but ATI’s own materials align most closely with actual exam content.
- 8 weeks minimum; 12 if science is weak. See the full TEAS preparation study plan for a week-by-week breakdown.
Preparing for the HESI A2
- Find out exactly which sections your program requires. Buying prep materials for sections you don’t need wastes time and money.
- Use Elsevier’s official HESI Admission Assessment Exam Review. The current edition (6th) covers all sections and includes practice questions aligned to the actual exam.
- Vocabulary is uniquely high-leverage for the HESI. The vocabulary section tests medical terminology that rarely appears on the TEAS. If you don’t have a clinical background, build in dedicated vocabulary time.
- Math for dosage calculations. Some programs use HESI math results to assess medication calculation readiness. Know your fractions, ratios, and unit conversions cold.
For both exams, consistent daily practice outperforms marathon study sessions. Block out 45–60 minutes per day rather than half-day weekend blocks.
If you’re applying to programs that require both
Some applicants apply to multiple programs that use different exams. In that case, you need to sit both. Plan your prep sequence:
- Prepare for one exam thoroughly before switching to the other
- Use your weaker content areas (typically science and math) as shared prep – they overlap significantly between exams
- Allow at least four weeks between sitting each exam to absorb material and recover test-taking capacity
Don’t try to parallel-prep for both exams at the same time. The content overlaps substantially, but the formats are different enough that switching back and forth during active study impairs retention.
FAQ
Can I use my ATI TEAS score at a HESI program?
No. These are separate exams from separate publishers. Programs that require the HESI A2 will not accept a TEAS score, and vice versa. Some schools accept either exam – check admissions requirements for each specific program.
Which exam is harder?
Neither is objectively harder. Difficulty depends on your background. The TEAS has fixed sections that everyone takes, including a full science component. The HESI’s difficulty depends on which sections your program requires – if they require chemistry and anatomy, it can be very demanding; if they only require math, reading, and vocabulary, the preparation load is lighter.
Do scores expire?
Yes. Most programs require TEAS or HESI scores from within the past two to three years. Confirm each program’s policy before registering to test – if you’re applying in one cycle and reapplying in another, you may need to retest. See nursing school prerequisites for more on how admissions timelines work.
What happens if I fail?
Both exams can be retaken, but two different policies govern and they are easy to conflate. ATI itself requires a 14-day wait between attempts at ATI-proctored test centers and sets no cap on total attempts. When a school administers the exam, the school’s own interval governs instead, and 30 days is the common institutional rule. Programs also set their own attempt limits – commonly two or three per admission cycle – and vary on whether they take your highest score, average your attempts, or count only the first. That second policy usually matters more than the waiting period, because it determines whether a retake can help you at all. Confirm both before your first sit.
Should I take a prep course?
Self-study works for most applicants if you follow a structured plan. Prep courses are worth considering if you’ve failed once already, if you have significant science gaps from older coursework, or if you work better with external accountability. Free resources (Khan Academy for math and science foundations) can close most content gaps without the expense.
References
- Assessment Technologies Institute (ATI), “What Is on the ATI TEAS, Version 7 Exam?” ATI Nursing Education, 2025.
- Assessment Technologies Institute (ATI), “TEAS Exam Details,” atitesting.com, 2025.
- Elsevier, “HESI Admission Assessment Exam Review, 6th Edition” (ISBN 978-0-443-11409-0), 2024.
- Elsevier Student Life, “HESI A2 Exam: Overview and Section Content,” Evolve, 2025.
- National Council of State Boards of Nursing (NCSBN), “NCLEX Examination Program Reports,” ncsbn.org, 2025.
- American Association of Colleges of Nursing (AACN), “Nursing Program Admission Requirements,” aacnnursing.org, 2025.
- Elsevier, “HESI Admission Assessment (A2) Scoring and Section Requirements,” us.elsevierhealth.com, 2025.
- Assessment Technologies Institute (ATI), “How soon can I retake the ATI TEAS Exam?” help.atitesting.com – 14-day wait between attempts at ATI-proctored centers; institution-administered exams follow the school’s own interval, commonly 30 days; no ATI-imposed cap on total attempts.
- Assessment Technologies Institute (ATI), “What is on the ATI TEAS, Version 7?” help.atitesting.com – 170 total questions comprising 150 scored and 20 unscored pretest items, 209 minutes total; per-section scored counts Science 44, Reading 39, Mathematics 34, English and Language Usage 33.
- Assessment Technologies Institute (ATI), “What is the cost of the TEAS Exam?” help.atitesting.com – $120 at ATI and PSI testing locations; institutions set their own price and may add proctor, scheduling, room or remote security monitoring fees.
- HESI A2 section structure – scored versus administered item counts (55-item sections carry 50 scored plus 5 unscored trial items; 30-item sections carry 25 scored plus 5 trial), cross-checked against institutional testing-center publications including Tarrant County College, “HESI A2 Exam Information,” tccd.edu, 2026.
- HESI A2 exam pricing – set by the administering institution rather than Elsevier. Published 2026 institutional prices span roughly $35–$115 (examples: Scottsdale Community College and Estrella Mountain Community College $45; Elmhurst University $51; Utah State University $65 HESI portion plus $30 institutional portion), with remote proctoring commonly adding about $25.