HESI 101

One school says you have to take HESI before you can apply to their nursing program.  Another school says you have to take HESI at the end of the program in order to graduate.  So what’s the deal?  What is this HESI, anyway? And more importantly, what do I need to do to pass it?!

filling out answers on a multiple choice test

In order to understand the rising popularity of the HESI, here’s a little background.  HESI stands for Health Education Systems Incorporated.  This is a company based in Houston, TX, that specializes in developing diagnostic tests for nursing and other healthcare fields.  In 2006, they were bought by the giant publishing company Elsevier.  Elsevier publishes many of the nursing textbooks that you probably already own, including Saunders NCLEX reviews and anything by Mosby.  And have you been to the Evolve website lately?  That’s Elsevier, too.

So back to HESI.  There are actually 3 types of HESI:  the HESI Admission Assessment exam (HESI A2), several specialty HESIs, and the HESI exit exam.  Every HESI exam is taken on the computer, each one of them is timed, and they’re all supposed to be able to predict something.  But what’s the differences, and what the heck are they supposed to be predicting?

HESI Admission Assessment exam (HESI A2)

The HESI A2 is frequently used by nursing programs as an entrance exam.  The HESI A2 does NOT ask any questions about nursing.  Instead, it tests you on seven general areas, including:  reading comprehension, vocabulary and general knowledge, grammar, basic math skills, biology, chemistry, and anatomy and physiology.  It also includes a learning style/personality assessment profile that is scored separately.

The purpose of the HESI A2 is to predict how well you’ll do in nursing school.  Does it make sense now why many nursing schools use it as an entrance exam?  Basically, the HESI company found out that students who score well on the HESI A2 tend to also do well in nursing school and go on to graduate.  On the other hand, they found that the students who do NOT score well on the HESI A2 tend to drop out or fail nursing school.

“But what a minute,” you yell, “I thought you said that the HESI A2 doesn’t even ask any nursing questions?”

You’re right.  It doesn’t.  But the assumption is that the skills and knowledge you need to succeed on the HESI A2 are the same skills and knowledge you need to be successful in nursing school. It’s kind of like the SAT or ACT of nursing school.  And of course, it can also make it easier for the nursing school to narrow down their loooong list of applicants.

HESI Specialty Exams

These are a little simpler to explain.  HESI offers a specialty content exam for many of the specific topics you’ll be covering in nursing school.  This includes an exam for Pediatrics, Maternity, Med-Surg, Psychiatric, Fundaments, Pharmacology, and probably some more that I’m forgetting right now.  Most schools will give these specialty exams to you at the end of the semester.  They’re helpful because they can measure how well you learned the material, and give you an idea of how much more you need to study and review in order to be prepared for NCLEX later on.

In some nursing schools, the score you get on the HESI Specialty Exam is used to calculate your final grade for that class.  But at other nursing schools, it is simply a way for you to get some feedback on how you’re doing, and doesn’t count toward your grade at all.  Check your syllabus or ask your nursing program how they typically to do it.

HESI Exit Exam

This is perhaps one of the most controversial and least understood of all the HESI exams.  Emotions tend to run high when nursing students talk about it, because the HESI exit exam can sometimes be the deciding factor as to whether they get to graduate.  Or not graduate.  Eek.

The purpose of the exit exam is to try and make sure that a nursing student is ready to take NCLEX.  If you do well on HESI, you’re supposed to be more likely to pass NCLEX.  If you do poorly on HESI, then your chances of passing NCLEX are lower.

The reason that nursing schools frequently use exit exams has to do with their NCLEX pass rate as recorded by the State board, and their accreditation status.  Without going into too much detail, here is a summary of how it works.  If a nursing school has too many students who fail the NCLEX the first time they take it, then their NCLEX pass rate gets lower.  It doesn’t even matter if the student passes on their 2nd try, because pass rates are only calculated using the first attempt.  So if the school’s NCLEX pass rate gets too low for too long, then they could lose their accreditation as a nursing school.

So it makes sense that nursing schools would want to feel reasonably confident that the new nursing graduates they’re sending out are ready to face the world…and pass NCLEX on the first try.  And one way that they do that is by requiring students to pass the HESI exit exam before they can graduate.

So That’s HESI in a Nutshell

So now that you know what all the different HESI’s are, what’s YOUR opinion about how it’s used by nursing schools?  Do you have any questions about HESI that I haven’t answered?  Because you KNOW that someone else out there is going to have that same exact question.  So ask it now in the comments section of this post; I’d love to answer it for you!

And stay tuned for some tips on how to succeed on HESI…

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12 Comments

  1. Maira

    Can you please help me what to become better to answer hesi questions. I failed my med-surg hesi LPN??
    Now I have to retake the class even though I passed the class with 87%

    Please, please I need help

  2. Calnetta Kier

    I would like info and help to pass hesi, I have weakness in math. I just want to be in the right direction. Please……..

  3. Paula

    My daughter passed the HESI exam but a job she accepted required a higher score. How can she retake it? Her nursing school is giving her a hard time about retaking it.

    • Hmm, I’ve actually never heard of an employer that even looks at the HESI score, usually as long as you’ve passed the NCLEX for your nursing license that’s all they want to know.

      But if she needs to retake it, she should try explaining the situation to the school AND offer to pay to retake the exam. The school has to pay for every HESI exam that is taken, so they might be more willing to allow her to retake it if she offers to pay.

  4. William Bielfeldt

    Any suggestions on study material for someone who will need to retake the HESI exit exam because their score was low the first time?

    Thank you

    • I can recommend a couple review books, but the more important issue is how you use them to study. The best review book in the world won’t help much if you use study strategy that don’t work well in nursing school. But I like the official HESI review book just because it gives you access to a few practice HESI exams. My all-time favorite review book is the Reviews and Rationales: Comprehensive NCLEX Review book by Mary Ann Hogan…has a ton of really well-written practice questions with it.

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