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 (scored) | 170 | Varies by sections required |
| Score format | Composite % (Total Mean Score) | Composite % by section |
| Typical minimum score | 58–75% composite | 75–80% composite |
| Retake policy | Set by program; typically 3–6 month wait | Set by program; typically 30–60 day wait |
| Cost | ~$115 (proctored) | ~$35–$70 (set by institution) |
| 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. All four are scored and all four count toward your composite.
| Section | Scored questions | Time | Key content |
|---|---|---|---|
| Science | 46 | 60 min | Human anatomy, physiology, biology, chemistry, scientific reasoning |
| Reading | 45 | 55 min | Passage comprehension, inference, text structure |
| Mathematics | 38 | 57 min | Numbers and algebra, measurement, data interpretation |
| English and Language Usage | 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.
| Section | Typical questions | Key content | Notes |
|---|---|---|---|
| Mathematics | 50 | Arithmetic, fractions, ratios, dosage | Required by most programs |
| Reading Comprehension | 47 | Main idea, inference, author purpose | Required by most programs |
| Vocabulary and General Knowledge | 50 | Medical and general vocabulary | Commonly required |
| Grammar | 50 | Parts of speech, sentence structure | Commonly required |
| Biology | 30 | Cell biology, genetics, metabolism | Required selectively |
| Chemistry | 30 | Atomic structure, reactions, acids/bases | Required selectively |
| Anatomy and Physiology | 30 | Body systems, organ function | Required selectively |
| Physics | 25 | 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 scored from 750 to 900 on a scaled format, then converted to a percentage equivalent. Programs typically set a composite minimum of 75–80%. 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.
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 (5th) 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 programs set their own retake windows and attempt limits. Most programs allow two to three attempts, with a waiting period of 30 to 180 days between attempts. Some programs accept your highest score; others require the most recent score. Know your program’s policy before your first attempt — it affects how much risk you can take on the initial 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.