TEAS vs HESI: Which Exam Do You Need & How to Ace Both
If you're applying to nursing school, you've almost certainly heard of TEAS and HESI. These two exams are the gatekeepers to nursing programs across the United States — and which one you need depends entirely on which schools you're applying to. Most students waste weeks studying for the wrong exam, or prepare for both when they only need one.
This guide cuts through the confusion. We'll explain exactly what each exam is, how they compare, what to expect on test day, and how to maximize your score on whichever one (or both) you need.
What is the TEAS?
The Test of Essential Academic Skills (TEAS) is developed by ATI (Assessment Technologies Institute) and is one of the most widely used nursing school entrance exams in the U.S. It tests foundational academic knowledge in four subjects that predict success in nursing school.
The current version is ATI TEAS 7, updated in 2022 with new content areas and question types.
TEAS Format — ATI TEAS 7
- Reading: 45 questions | 55 minutes — Passage comprehension, informational sources, evidence-based reasoning
- Mathematics: 38 questions | 57 minutes — Numbers/algebra, measurement/data, statistics
- Science: 50 questions | 60 minutes — Human anatomy, life science, physical science, scientific reasoning
- English & Language Usage: 37 questions | 37 minutes — Conventions, vocabulary, sentence structure
Total: 170 questions | 209 minutes (plus breaks)
What is the HESI?
The Health Education Systems, Inc. (HESI) A2 exam is developed by Elsevier and serves a similar gatekeeping function as the TEAS, but with different content distribution and scoring. It is required by many nursing and allied health programs as part of their admissions process.
HESI A2 Format
- Mathematics: 50 questions | 50 minutes — Basic math, fractions, dosage calculations
- Reading Comprehension: 47 questions | 60 minutes — Passage reading, main idea, inference
- Vocabulary & General Knowledge: 50 questions | 50 minutes — Medical and general terms
- Grammar: 50 questions | 50 minutes — Parts of speech, sentence structure, punctuation
- Biology: 25 questions | 25 minutes
- Chemistry: 25 questions | 25 minutes
- Anatomy & Physiology: 25 questions | 25 minutes
- Physics: 25 questions | 25 minutes (less common — not all schools require it)
Note: Schools often require only specific sections. Always check which sections your target program requires.
TEAS vs HESI: Side-by-Side Comparison
| Feature | TEAS 7 | HESI A2 |
|---|---|---|
| Developer | ATI | Elsevier |
| Test Length | 170 questions | Varies by sections required |
| Time Limit | ~3.5 hours | ~4–5 hours (all sections) |
| Format | Computer-based | Computer-based |
| Retake Policy | Varies by program (typically 90 days) | Varies by program (typically 60–90 days) |
| Passing Score | Program-specific (typically 62–78%) | Program-specific (typically 75–80%) |
| Delivery | ATI Testing Centers or remotely | School-administered, some at testing centers |
| Subject Focus | Reading, Math, Science, English | Math, Reading, Vocab, Grammar, Sciences |
| Harder Section | Science (anatomy & physiology heavy) | Math (includes dosage calculations) |
| Best Study Prep | ATI TEAS study guide + practice tests | HESI A2 study guide + flash cards |
Which Exam Do You Need?
The simplest answer: check each nursing school's admission requirements. There is no rule that dictates which exam a program uses. Many programs accept either, while others are specific.
Programs affiliated with ATI products (very common at community colleges and many university programs) tend to require TEAS. Programs using Elsevier nursing textbooks often require HESI. But always verify directly with your target programs — this is a general pattern, not a rule.
Programs That Commonly Require TEAS
- Most community college ADN (Associate Degree in Nursing) programs
- Many university BSN programs
- Programs in states like California, Texas, and Florida often favor TEAS
Programs That Commonly Require HESI
- Programs that use Elsevier textbooks throughout their nursing curriculum
- Some private university programs
- Programs in the South and Southeast U.S. tend to favor HESI A2
What Score Do You Need?
Passing scores vary significantly between programs. Here are general benchmarks:
Competitive programs want 75%+
Competitive programs want 80%+
For highly competitive nursing programs, you'll want to aim 10–15 points above the minimum. Admissions committees often rank candidates by exam score, GPA, and other factors. A higher TEAS or HESI score can be the difference between admission and a waitlist.
How to Prepare: TEAS-Specific Strategy
Science (Most Challenging for Most Students)
TEAS Science is 50 questions and heavily weighted toward Anatomy & Physiology, Life Science, and Scientific Reasoning. Focus on:
- All major body systems (cardiovascular, respiratory, musculoskeletal, nervous, immune, renal, endocrine, reproductive)
- Cell biology: mitosis, meiosis, protein synthesis, DNA vs RNA
- Basic chemistry: pH scale, atoms, molecules, chemical bonds
- Ecology and biology basics
Mathematics (Most Commonly Underestimated)
TEAS 7 math includes algebra, proportions, measurement conversions, and basic statistics. Don't ignore statistics — it's a new addition to TEAS 7 and many students are caught off guard.
Reading (Most Scoring Opportunity)
Reading is one of the highest-scoring sections for most students. Practice:
- Finding main ideas and supporting details
- Making inferences and drawing conclusions
- Understanding author's purpose and tone
- Reading charts, graphs, and informational graphics
How to Prepare: HESI-Specific Strategy
Mathematics — Dosage Calculations
HESI math includes nursing-relevant dosage calculations. This is a differentiator from TEAS. Practice:
- Dimensional analysis (units conversion)
- IV flow rates
- Drug calculations (mg/kg dosing)
- Ratio and proportion
Vocabulary — Medical Terminology
The HESI Vocabulary section includes medical terms you may not have encountered in general study. Build a dedicated flashcard deck of medical prefixes, suffixes, and root words. At minimum, know:
- Prefixes: brady-, tachy-, hyper-, hypo-, anti-, inter-, intra-, poly-
- Suffixes: -itis, -ectomy, -plasty, -oscopy, -algia, -emia, -osis, -pathy
- Body system terminology for all major systems
Grammar
HESI Grammar tests sentence structure, punctuation, and parts of speech more explicitly than TEAS. Brush up on comma rules, subject-verb agreement, and commonly confused words (their/there/they're, affect/effect, etc.).
Most students need 4–8 weeks of focused prep to achieve a competitive score on either exam. Spend more time on your weak subjects and take at least 2 full practice tests in timed conditions before your exam date.
How BAM Helps with TEAS & HESI
Our TEAS and HESI preparation services are the most comprehensive available. When you work with Brilliant Academic Minds:
- You receive a diagnostic assessment that identifies exactly which topics need the most attention
- Your dedicated expert creates a personalized study plan based on your test date and baseline score
- We provide content review, practice questions, and full-length mock exams in the exact format of your target exam
- For HESI, we have specialized dosage calculation coaching — the section that most students struggle with
- For TEAS, we provide focused science content review covering all high-frequency topics
- We offer a score guarantee — if you don't meet your target score, we work with you until you do
Ready to Ace Your TEAS or HESI?
Expert-guided preparation with a proven track record. Start today and get into your nursing program.