44. What is the HESI Exam? (Part 2-Exit Exam)

What is the HESI Exam for nursing school? Is the HESI exit exam harder than the NCLEX? What’s the best way to study for it? And what should you do next if you FAIL it?

Today is the second in a 3-part series about HESI Exams to clear up a lot of misunderstandings about them, as well as answer the most common questions that I see asked. Even if you never have to take a HESI exam in your life, it’s still really important for you to learn a little bit about it because you never know when you’ll have an opportunity to mentor someone else on their nursing journey in the future…and that student might have to deal with HESI! So you’ll want to be able to point them in the right direction, instead of accidentally continuing to spread all the common myths, so that you can actually DO help them.

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Links from Episode 44:

My favorite NCLEX Review book (buy new so you get online access to review questions!): https://amzn.to/3DFeD2W

Looking for info on HESI A2 Admission Exam? Try: www.YourNursingTutor.com/episode43

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Transcript for Episode 44

What is the HESI Exam for nursing school? Is the HESI exit exam harder than the NCLEX? What’s the best way to study for it? And what should you do next if you FAIL it?

Hello, and welcome to Episode 44 of Navigating Nursing School with Your Nursing Tutor! Today is the second in a 3-part series about HESI Exams to clear up a lot of misunderstandings about them, as well as answer the most common questions that I see asked. Even if you never have to take a HESI exam in your life, it’s still really important for you to learn a little bit about it because you never know when you’ll have an opportunity to mentor someone else on their nursing journey in the future…and that student might have to deal with HESI! So you’ll want to be able to point them in the right direction, instead of accidentally continuing to spread all the common myths, so that you can actually DO help them. 

This episode got recorded a little bit later than I usually like to record, like closer to the deadline for publication than usual, because we’ve had a lot going on in our household this week. And just like when you’re in nursing school, when you have unexpected things pop up then you need to pivot and adjust to make room for them! Because life does not stop just because you’re in nursing school, and it doesn’t stop just because I’m a professional nursing tutor with a podcast either, am I right?

Two things happened in my family this week that messed up my flow. First was my 6-year old, which is my kid who is the most accident prone of all my 6 kids. He’s the only one to have had broken a bone so far, and he’s needed both stitches AND staples at 2 different times. So this past week, it was bedtime, and I usually like to work on Your Nursing Tutor stuff a little bit after my kids go to bed, but just as they were supposed to be lights out, my 6-year old starts screaming. And it was the type of “real” scream that, as his mom, I KNEW was something serious. 

So he comes running into my office, crying so hysterically that he can’t even tell me what happened, so he just shows me his little pointer finger…and there’s a staple in it. The kid had literally stapled his own finger. I guess someone had left the stapler lying around, and he just got curious about how it worked, and had his finger in the wrong place, at the wrong time. It was in there pretty good, but we were able to pull it out with a pair of pliers. And I cleaned it up and bandaged it, and we kept an eye on it for a few days but it healed just fine with no infection or anything. So that was kind of an exciting night, but I’m glad we were able to avoid the ER at least.

And then just yesterday, on the day before I am recording this episode, my husband threw his back out. And it’s one of those things where he WISHES it was an interesting story, but really he was just bending over to take his shoes off. 

Normally, he’s the one wrangling our 6 kids all day and supervising their homeschool stuff while I work with our VIP Tutoring Members, but obviously he can’t do that when he’s in so much pain that he can’t even walk. So I’ve been trying to squeeze in work when I can, and wrangle the kids at the same time. But our best friend came by today to watch the kids for a few hours so that I could get this podcast episode finished, and I’m really thankful for her help! It’s so much easier to do life when you have a good support system in place. 

So anyway, that’s what’s been going on over here at the Your Nursing Tutor household! If you’d like to drop me a line and let me know what’s going on in YOUR life, I always love hearing from my listeners.

So in the last podcast episode, I started by talking about the HESI A2 Admissions exam, which commonly gets mixed up with the other HESI Exams, like the HESI Exit Exam and the HESI Specialty Exams. But now you know that the HESI A2 is actually a completely different exam then the other two, and doesn’t contain any nursing specific information on it, since it’s evaluating the pre-requisite knowledge you need before starting nursing school. 

The other 2 types of HESI’s however, are all nursing information. Which is why today, we’re going to jump to the other end of nursing school to discuss…

What is the HESI Exit Exam?

The HESI Exit Exam is a cumulative nursing exam that is usually given at the end of all your nursing courses, right before graduation. 

And it’s also important to understand that if you’re listening to this and you’re still pre-nursing, then you definitely need to be aware of the HESI Exit Exam before you even choose a nursing school. It can give you some very important information about how well your nursing school will prepare you to get your license. Because…

What is the purpose of the HESI Exit Exam?

The purpose of the HESI Exit Exam is to predict how likely you are to pass NCLEX on your first try. It’s as simple as that, but it can also be used for both good and evil, depending on how your school implements it. 

That may sound a little bit overly dramatic, but let me explain. 

Ideally, the HESI Exit Exam will help YOU, as a student, know if you are prepared to pass the NCLEX. It’s sort of like a practice NCLEX, in that sense. And while they can’t tell you 100% for sure if you will pass NCLEX, because, what if you do well on HESI but then you’re having a bad day when you go to take your NCLEX or something, well you still might fail NCLEX in that case. So it’s impossible to be 100% accurate with this.

But that being said…

Is HESI a good predictor of NCLEX?

Despite those limitations, the HESI Exit Exam is actually a really good predictor of NCLEX success because they use a LOT of data from nursing students all over the country. 

Basically, these kinds of large scale, cumulative  Exams are the next best thing to actually taking NCLEX. And that includes other exit exam companies like ATI, and also many of the big Test Prep companies that are also able to collect a large amount of testing data from students all over the country.

So yes, the HESI IS a good predictor of NCLEX: if you score high on your HESI Exit Exam, then there is a high probability that you will also pass NCLEX on your first try. The way they make this prediction is because the vast majority of other nursing students who got that same score also went on to pass NCLEX on their first try.

On the flip side, if you score low on your HESI Exit Exam, then there is a high probability that you will FAIL NCLEX on your first try, because the vast majority of other nursing students who got that same lower HESI score also went on to fail NCLEX on their first try. 

But either way, your HESI Exit Exam score is not a guarantee that you will pass or fail NCLEX on your first try. But it can be reassuring if you score well, and it can serve as a red flag that you need to do more intensive preparation if you score lower. So that’s the good news about the HESI Exit Exam.

Now the bad news. 

Why HESI Exit Exams should matter even to Pre-Nursing Students

Sometimes nursing schools will use the HESI Exit Exam, or really any exit exam like ATI for example, to artificially increase their NCLEX Pass rates. And I’m going to explain what I mean by that. 

If you’re pre-nursing and looking for a good nursing school, or you’re already in school and think back to when you were at that step in your nursing journey, then I’m sure you’ve heard the advice that you should check your state’s Board of Nursing website to discover your school’s NCLEX Pass rate.

The NCLEX Pass Rate is calculated based on how many graduates pass NCLEX on their first try. And the stakes are high, because if a school’s pass rate drops too low for too long, then they can lose their accreditation. Which is bad for them, and obviously bad for YOU as a student, too. Not to mention the fact that if they have a bad pass rate, then they’re not preparing their graduates very well to think like a nurse through their courses.

So what sometimes happens is that if a school is struggling to maintain an adequate NCLEX Pass rate so that they can keep their accreditation, then they might start using an Exit Exam like HESI to help. 

They do this by creating a graduation requirement that students must pass their HESI Exit Exam with a certain minimum score. This minimum score is associated with a high likelihood of passing NCLEX on the first try. So far so good. But any student who doesn’t achieve that score will not be allowed to graduate, which means they won’t be allowed to take NCLEX. 

Now don’t get me wrong, there’s nothing inherently wrong with using a HESI Exit Exam this way. The main problem comes when schools use it to artificially inflate their passing numbers. For example, if they have 20 students in a cohort, and 15 score too low on their HESI to graduate, then the remaining 5 students will graduate and have a chance to take NCLEX. And odds are good that all 5 will pass and get their license! So according to the public numbers, that school would have a 100% NCLEX Pass Rate. Which obviously looks really good for them. 

But in reality, they only have a 25% graduation rate! Because the remaining 15 students were not allowed to graduate and take NCLEX at all. 

Now I don’t tell you this to scare you. Because in all honesty, I don’t think this happens as much nowadays as it used to way back when I first started Your Nursing Tutor over 10 years ago. 

Back then, these types of Exit Exams were just beginning to become more common, and I would occasionally hear from a student who was in that exact situation, and freaking out because they didn’t know what to do next or what their options even were. 

This is the exact reason why I always recommend that pre-nursing students inquire about the Exit Exam policies at any nursing school you’re considering, in addition to doing your due diligence and finding out your school’s NCLEX Pass Rate. 


What’s the best way to prepare for HESI Exit Exam

The best way to prepare for HESI Exit Exam is simply to learn how to study in a way that trains you to think like a nurse starting from Day 1 of nursing school. It’s the same exact way that I recommend preparing for NCLEX, by the way. 

Now follow this logic: the point of nursing school is to prepare you to become a safe, effective, beginning, nurse. And so NCLEX is there to assess if you have the knowledge foundation and philosophy to be a safe, effective, beginning, nurse. And therefore, since HESI needs to assess if you can pass NCLEX, then HESI is ALSO assessing if you are able to think like a safe, effective, beginning, nurse. 

And that is what nursing school has been supposed to be gradually teaching you from day 1. 

This is the same reason why I always tell my Your Nursing Tutor VIP Tutoring students that if you study using the Silver Bullet Study System all the way through nursing school, then you can learn how to think like a safe, effective, beginning nurse even if you’re left to teach yourself. 

In fact, when you study this way, nursing school will get easier instead of harder as you progress. Back when I was in nursing school, that was my experience. And now I’ve seen it happen for so many of my tutoring students. 

But when you DON’T study this way, nursing school will get HARDER instead of easier as you go. And then you get to the HESI Exit Exam, and you panic. Because now it’s cumulative, and it just got real

While it’s tempting to try to cram with an NCLEX review book, that’s really not enough. You need to study with a focus of learning how to think like a nurse, or else you’re going to continue to struggle. 

Side note: NCLEX Review books aren’t all bad, and I’ll link to my favorite one in the show notes page. 

But struggling to pass HESI is not inevitable if you’re studying strategically, and while it’s always going to be easier to start off nursing school by studying the right way, the good news is that it’s never too late to change the way you study. 

And in most cases, you can still see improvements in your test scores pretty quickly, because you’ve probably already been studying really hard through your nursing classes and you DO actually know more than you think you do. 

The problem is just that you haven’t been studying in a way that organizes it so you can recall it easily when you need to answer a question, and then be able to analyze and APPLY that information so you can answer the questions correctly, too. And that’s exactly what I show you how to do in the VIP Tutoring Membership at www.YourNursingTutor.com/vip


Is HESI harder than Nclex?

I see this question asked a lot, but HESI and NCLEX are very different types of tests, so the answer requires some explanation. 

What is important to remember is that NCLEX is a “Computer Adaptive Test”, otherwise called a “CAT” test. This means that it automatically adjusts the difficulty level of each question you answer based on how you’re doing overall. So if you’re consistently getting questions correct, then NCLEX will gradually start giving you harder and harder questions until you start getting them wrong more consistently. Then it will adjust the difficulty level down again.

The NCLEX tests you this way because they’re trying to assess at what difficulty level you can correctly answer most questions at. If that difficulty level is higher than what they’ve determined a safe, effective, beginning nurse should perform at, then you pass.

But if that difficulty level you can answer correctly at is lower than what they’ve determined a safe, effective beginning nursing should perform at, then you unfortunately will fail.

This “adaptive” feature is also the reason why almost everybody walks out of NCLEX feeling like they failed. 

Because no matter how well prepared you are, the test WILL get harder and harder until you’re getting some questions wrong. But by the time you advance to a certain difficulty level, getting questions wrong does NOT mean that you’re failing. 

I hope that makes sense, but if not then let me know because I’m always open to finding different ways to explain the same concept, I think that’s one of my “superpowers” as a professional nursing tutor, and I find it really fun to do!

But the reason why it’s important to understand the difference between CAT testing like you see on NCLEX, versus a HESI exam, any HESI exam, is because the HESI exam is NOT adaptive. Everybody gets the same exact questions each time they take that same version of HESI.

This means that ALL the HESI exam questions have to be difficult enough to assess whether you could consistently answer above the “passing level” on NCLEX. Otherwise HESI would not be very good at predicting if you could pass enough of the difficult NCLEX questions on your first try.

So in that sense, yes…I personally DO think that the HESI Exit Exam is probably a bit harder than the NCLEX is for most people. Because the average difficulty level of the HESI questions has to be hard enough to be above the passing level in NCLEX.

This creates a situation where if you’re really EXTRA good at correctly answering NCLEX questions, then NCLEX could potentially end up feeling a lot harder than HESI. But this is going to be a small percentage of future nurses that are in this situation.

Because for the majority of students, you’ll probably end up adapting into a slightly lower difficulty level than what you had on HESI, and still be able to pass NCLEX. This situation is probably the most common one, in my experience, so it would leave you feeling like HESI was a lot harder than NCLEX was. 

Thinking back to my personal experience, I found them to be roughly the same. On my HESI Exit Exam, which my school DID require for graduation, I was able to pass on my first try with a strong score. I remember feeling like it was a reasonable test, because I had been studying using my Silver Bullet Study System Method since I discovered it early on during my first semester in nursing school. So it felt challenging to me, but in a good way, if that makes sense. I had a lot of confidence going into my HESI Exit Exam, and I actually thought it was kind of fun. 

Then when I took NCLEX, my test shut off at 75-questions, and I walked out feeling certain that I had failed!! Just like almost everybody feels like, as I said. But then a couple of days later I checked my Board of Nursing website and discovered that my RN license number had posted, and that’s how I found out I had passed!

What happens if you don’t pass the HESI? What happens if you fail the HESI exam?

It’s extremely important to know what your school’s policy for HESI Exit Exams is. Since HESI is a predictive tool, there is technically no “pass or fail”. It all depends on how your particular school wants to use it. 

Some schools make it a weighted part of your final grade for a core nursing class. In this scenario, scoring well will boost your grade, while scoring lower will decrease your final grade. But even if you fail your HESI, you could still pass your class as long as the rest of your grades are strong enough.

Other schools make the HESI Exit Exam a requirement more similar to your Dosage Calculations test…it’s pass/fail. In this scenario, you could potentially fail your entire class and be prevented from graduating based on this single test alone, even if you literally got straight A’s in all of your other nursing classes. 

But that is very unlikely to happen, FYI. So I don’t say that to increase your anxiety, just to remind you of the importance of fully understanding your school’s specific Exit Exam policies. 

But if you DO fail it, then…

How many times can you take the HESI exam? Can I take the HESI twice?

Again, it really depends on the school.

In my experience talking with nursing students across the country, it seems like most schools will allow a second attempt at the HESI Exit Exam within a week or two of your first attempt. If you’re able to achieve the required score on your second attempt, then they would still allow you to graduate as long as your other graduation requirements are met. 

Most schools won’t let you retake the exam more than twice without some sort of remediation, though. That “remediation” may involve meeting with a tutor, retaking an entire class, or even being left on your own to study for a certain amount of time before being allowed to retake. 

Some schools only give you a certain number of attempts to get the desired score on HESI before removing you from the program, which is kind of scary and depressing when you’ve successfully completed all the other requirements and that is literally the only thing holding you back.

And if you’re in that situation, then you’ll probably need a little extra tutoring support than what my regular VIP Tutoring Membership offers. A situation like that would call for my Tutor On-Call program, which includes the VIP Tutoring Membership PLUS adds 24/7 access directly to me through Voxer, which is a free voice and text message app. That way I can give you that extra help and direction that you would need to remediate and prepare to retake your HESI Exit Exam successfully next time. 

I only take a limited number of nursing students at a time into the Tutor On-Call program, which allows me to offer the best tutoring service possible. But if there aren’t any openings when you check, then make sure you sign-up to get on the waitlist and you’ll be first to be notified when the next openings become available.

In next week’s episode, we’re going to go right smack dab back into the middle of nursing school HESI Exams by talking about the Specialty Exams for each of your classes like Fundamentals, Med-Surg, Dosage Calc, Pharmacology…pretty much all of ‘em. So make sure that you subscribe to the Navigating Nursing School Podcast, and please leave a rating and review on Apple Podcasts while you’re at it. 

I have one more tip I want to share with you today…when I had some unexpected things happen in my life this week with my family, I was able to pivot and still get the most important things done that I needed to. 

When you’re in nursing school, you need to have that same ability to pivot when unexpected things pop up in YOUR life, so that you can also see success in nursing school. There’s actually TWO main strategies for addressing this problem, and if you use them both together then you’ll feel best prepared for any surprise situations that life will throw at you. 

First, you need to become a Time Management Rock Star so that you have time to do what’s most important AND still leave white space on your calendar for when unexpected things pop up…because let’s be totally honest, unexpected things WILL pop up, we just don’t know exactly when. But that also means they’re not totally unexpected…so there are ways to prepare for them. 

Second, you need to keep your test grades solidly in the passing range so that you have enough “grade space” to handle a crisis week where your studying might slip due to unforeseen circumstances. When you have an unexpected crisis, you really need to be able to focus on dealing with that crisis. But if your attention is divided with worry and stress about failing nursing school, then you’ll have the additional pressure of dealing with TWO crises at the same time! And you don’t want to be doing that to yourself in nursing school. 

But if your grades are already solid, then if your test grade slips a little bit one week because of the other things going on in your life, then it’s not as big of a deal because you’ll still have confidence that you’re ultimately going to pass. 

The good news is that the VIP Tutoring Membership will help you create BOTH of those solutions at the same time! So if you’d like to work with me to lower your nursing school stress and feel more confident that you WILL rock this nursing school thing, then join me in the VIP Tutoring Membership by going to www.YourNursingTutor.com/vip

Until next time, good luck on your nursing journey!

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