If you're applying to nursing school in 2026, you've probably searched "TEAS vs HESI" or "difference between TEAS and HESI" and found confusing, vague answers. This guide ends that. The ATI TEAS and HESI A2 are the two most common nursing school entrance exams in the United States — but they are not the same test. They differ in structure, timing, content, scoring, cost, and which schools accept which exam. Below we break down every meaningful TEAS and HESI difference so you can study smarter, not harder.
Quick answer to "should I take the TEAS or HESI?": You don't always get to choose — your target nursing program tells you which one to take. Some accept both. Most require one or the other. Check your program's admissions page first, then come back here to learn exactly what you're up against.
What Is the Difference Between the TEAS and HESI Exams?
| Feature | ATI TEAS 7 | HESI A2 |
|---|---|---|
| Full name | Test of Essential Academic Skills, Version 7 | Health Education Systems Incorporated Admission Assessment |
| Publisher | ATI Nursing Education | Elsevier (part of RELX Group) |
| Sections | 4 fixed sections | Up to 10 modules (school chooses which) |
| Total questions | 170 (150 scored + 20 pretest) | Varies — typically 250–300 depending on modules |
| Time limit | 209 minutes (3 hr 29 min) | Varies — typically 4–5.5 hours depending on modules |
| Scoring | Composite percentage (0–100%) | Individual module scores (0–100%) + cumulative |
| Cost | $100 (in-person) / $115 (remote) | $40–$100 (varies by institution) |
| Remote testing | Yes (ATI remote proctoring) | Depends on institution — most require on-campus |
| Calculator | On-screen 4-function (Math only, some items no-calculator) | On-screen calculator provided for Math section |
Do Nursing Schools Prefer TEAS or HESI?
This isn't a matter of preference — it's determined by your nursing program.
Schools that typically require the TEAS:
- Most Associate Degree in Nursing (ADN) programs at community colleges
- Many BSN programs at state universities
- Programs that use ATI throughout the curriculum (ATI is both the test publisher and a major nursing education platform — schools invested in ATI's ecosystem tend to require the TEAS)
- Examples: Chamberlain University, Rasmussen University, most Texas community colleges, many California State University campuses
Schools that typically require the HESI:
- Programs that use Elsevier/Evolve products throughout the curriculum
- Many private nursing schools and for-profit institutions
- Some large BSN and MSN programs at research universities
- Examples: University of Texas at Arlington, Florida Atlantic University, many HCA-affiliated programs
Schools that accept both:
A growing number of programs accept either the TEAS or the HESI. If your school falls into this category, you have a choice — and we'll help you make it by the end of this article.
Action step: Go to your target program's admissions page right now and search for "entrance exam," "TEAS," or "HESI." Confirm which exam they require before you spend a dollar on prep materials.
TEAS vs HESI Sections: How Many Questions Are on Each Exam?
ATI TEAS 7 — 4 Fixed Sections
Every TEAS test-taker gets the exact same four sections in the same order:
| Section | Questions | Time | Key Topics |
|---|---|---|---|
| Reading | 45 | 55 min | Key ideas & details, craft & structure, integration of knowledge |
| Mathematics | 38 | 57 min | Numbers & algebra, measurement, data interpretation |
| Science | 50 | 63 min | Human anatomy & physiology, biology, chemistry, scientific reasoning |
| English & Language Usage | 37 | 34 min | Conventions of English, vocabulary, knowledge of language |
What this means for you: The TEAS is predictable. Every student takes the same four sections with the same number of questions and the same time limits. You know exactly what to prepare for.
HESI A2 — Modular (Up to 10 Sections)
The HESI A2 has up to 10 subject modules, but your school decides which ones you take. No student takes all 10. Most programs require 5–8 modules.
| Module | Questions | Time | Commonly Required? |
|---|---|---|---|
| Mathematics | 55 | 50 min | ✅ Almost always |
| Reading Comprehension | 55 | 60 min | ✅ Almost always |
| Vocabulary & General Knowledge | 55 | 50 min | ✅ Almost always |
| Grammar | 55 | 50 min | ✅ Almost always |
| Biology | 30 | 25 min | ✅ Very common |
| Chemistry | 30 | 25 min | ✅ Common |
| Anatomy & Physiology | 30 | 25 min | ✅ Common |
| Physics | 30 | 25 min | ⚠️ Rare — a few BSN programs |
| Learning Style | 14 | 15 min | ⚠️ Not scored, sometimes included |
| Personality Style | 15 | 15 min | ⚠️ Not scored, sometimes included |
What this means for you: Your HESI exam might look completely different from a friend's HESI at a different school. Before you start studying, get the exact list of required modules from your program. Don't waste weeks studying Chemistry if your school doesn't test it.
Is the HESI Harder Than the TEAS? (Or Is the TEAS Harder?)
"Is the HESI harder than the TEAS?" and "is the TEAS harder than the HESI?" are two of the most-searched nursing exam questions online. The honest answer: it depends on the subject and your personal strengths. Here's a section-by-section breakdown of TEAS vs HESI difficulty.
Math
The TEAS Math section is generally considered slightly harder than the HESI Math. The TEAS includes more algebra, multi-step word problems, and data interpretation. The HESI Math is more focused on basic operations, fractions, decimals, percentages, ratios, and conversions — closer to what you'd see in a pre-algebra course. If you're comfortable with algebra, the TEAS math won't feel much harder. If math is your weakness, the HESI math may feel more approachable.
Science
The HESI breaks science into separate modules (Biology, Chemistry, A&P, Physics), while the TEAS combines all science into one 50-question section. The HESI science modules tend to go deeper into each individual subject — more specific anatomy questions, more detailed chemistry. The TEAS science is broader — it covers biology, chemistry, A&P, and scientific reasoning all in one section, so questions span more topics but with less depth per topic.
Bottom line on science: If you've taken college-level A&P and chemistry, the HESI science modules will feel familiar. If you haven't, the TEAS science section is somewhat more forgiving because it doesn't go as deep — but you still need foundational knowledge across all areas.
Reading
Both exams test reading comprehension with passage-based questions. The TEAS Reading section tends to include more analytical questions — identifying author purpose, evaluating arguments, integrating information from multiple sources. The HESI Reading is more straightforward comprehension — main idea, supporting details, inference from a single passage. Most students find both reading sections manageable if they practice.
English / Vocabulary / Grammar
The TEAS combines grammar, vocabulary, and language usage into one section (37 questions, 34 minutes) — it's fast-paced and covers conventions of standard English, vocabulary in context, and sentence structure.
The HESI splits this into two separate modules: Vocabulary & General Knowledge (55 questions) and Grammar (55 questions). The HESI Vocabulary section is notorious among students — it tests medical and academic vocabulary that you may not encounter in everyday reading. Words like exacerbation, bilateral, contraindicated, and lethargic. If vocabulary isn't your strength, the HESI vocabulary module requires dedicated memorization.
TEAS vs HESI: Which Is Easier Overall?
TEAS is harder if: You struggle with algebra, multi-step math problems, or timed pressure (the English section gives you only ~55 seconds per question).
HESI is harder if: You haven't taken college-level science courses (the individual science modules go deep), or if medical/academic vocabulary is a weakness.
Neither is universally harder. They test similar knowledge at similar levels, just organized differently.
TEAS vs HESI Scores: How Is Each Exam Graded?
TEAS Scoring
You receive four individual section scores plus a composite score — a weighted average of all four sections. All scores are expressed as percentages (0–100%). The composite score is what most schools look at.
Typical minimum scores for nursing programs:
- Community college ADN programs: 58–65% composite
- BSN programs: 65–78% composite
- Competitive BSN programs: 78%+ composite
- National average: ~65%
ATI also provides percentile ranks — how your score compares to all other test-takers nationally. A composite of 78% might put you in the 90th percentile, for example.
HESI Scoring
Each module is scored individually on a scale of 0–100%. There is also a cumulative score (average of all modules you took). Schools may look at individual module scores, the cumulative score, or both.
Typical minimum scores for nursing programs:
- Minimum to apply: 75% on each required module (common threshold)
- Competitive programs: 80–90% per module
- Highly competitive programs: 90%+ per module
Key difference: With the HESI, a low score on one module can disqualify you even if your other scores are excellent. On the TEAS, a weak section can be partially offset by strong performance in other sections since they're blended into a composite.
TEAS vs HESI Cost: How Much Does Each Exam Cost?
| Expense | TEAS | HESI |
|---|---|---|
| Registration (in-person) | $100 | $40–$100 (set by institution) |
| Remote proctoring | $115 | Rarely available remotely |
| Additional score transcript | $27 per school | Usually included / varies |
| Retake fee | $100–$115 (full price) | $40–$100 (full price, set by institution) |
The HESI tends to be cheaper per attempt, but costs vary widely by institution. The TEAS has a fixed, transparent price through ATI. If you're applying to multiple schools and need score transcripts sent, the TEAS's $27-per-transcript fee adds up quickly.
TEAS vs HESI Retake Policy: How Many Times Can You Retake Each Exam?
TEAS Retakes
- Up to 3 attempts within a 12-month period (through ATI)
- 30-day mandatory wait between attempts
- Individual school policies may be stricter (some only accept 2 attempts or require 60–90 day waits)
HESI Retakes
- Retake policies are set entirely by each institution — Elsevier doesn't enforce a universal limit
- Most schools allow 2–3 attempts per admissions cycle
- Wait periods vary: some schools allow immediate retakes, others require 30–60 days
- Some programs require you to retake all modules even if you only failed one
The retake lesson is the same for both exams: Treat your first attempt as your best shot. Retakes cost money, delay your application timeline, and some programs penalize multiple attempts. Invest in solid preparation upfront.
How to Study for the TEAS vs How to Study for the HESI
Studying for the TEAS
Because the TEAS is standardized with fixed sections, your study plan is straightforward:
- Take a diagnostic test to identify your weakest section
- Prioritize Science (heaviest section at 50 questions) and Math (most students' weakest area)
- Practice under timed conditions — especially English (34 minutes for 37 questions is brutal)
- Study 4–6 weeks for 1–2 hours daily
- Use practice questions with rationales — not just flashcards
Studying for the HESI
Because the HESI is modular, your study plan depends on which modules your school requires:
- Get your school's required module list first
- Prioritize Vocabulary — this is the module that surprises students most. Start memorizing medical and academic vocabulary 4+ weeks out
- Review A&P systems if your school requires the Anatomy & Physiology module — it goes deeper than the TEAS equivalent
- Don't neglect Grammar — 55 questions specifically on grammar rules
- Study 4–8 weeks depending on how many modules you're taking
Best Study Resources for Both
Our practice PDFs are designed to match the real exam format, difficulty, and content distribution:
Which Nursing Schools Require the TEAS vs HESI?
There's no single master list, but here's a general pattern based on common program types:
| Program Type | TEAS | HESI | Both |
|---|---|---|---|
| Community college ADN | ✅ Most common | Some | Rare |
| State university BSN | Common | Common | Growing |
| Private university BSN | Some | ✅ Most common | Some |
| Accelerated BSN / ABSN | Common | Common | Increasing |
| LPN/LVN programs | ✅ Most common | Some | Rare |
Should I Take the TEAS or HESI? (If Your School Accepts Both)
If your nursing program accepts either the TEAS or the HESI, you get to play to your strengths. Here's a decision framework for choosing between the TEAS and HESI:
Take the TEAS if:
- You're stronger in math (algebra, word problems)
- You want a predictable, standardized test with no surprises about which sections you'll face
- You want the option to test remotely from home
- You prefer a composite score where a strong section can offset a weaker one
- You haven't taken college-level science courses (TEAS science is broader but less deep)
Take the HESI if:
- You have strong science backgrounds — especially if you've completed A&P, Biology, and Chemistry
- You have a strong vocabulary (medical terminology background helps enormously)
- You want more time per question in most sections
- You want a potentially lower registration cost
- You're okay with a longer testing session (5+ hours with multiple modules)
How Long Are TEAS and HESI Scores Valid?
TEAS: ATI doesn't set an official expiration. Most nursing schools accept TEAS scores from the past 2–3 years. Some competitive programs only accept scores within 12 months.
HESI: Elsevier doesn't set an official expiration either. Most schools accept HESI scores from the past 1–2 years. A few programs require scores from within the current admissions cycle.
Always confirm validity windows with your specific program — this is one of the most commonly overlooked details in nursing school applications.
TEAS or HESI: Which Nursing Entrance Exam Is Right for You?
Whether you end up taking the TEAS or the HESI, the exam itself is determined by your school. What you can control is how well you prepare. Students who use structured practice questions with detailed answer rationales consistently outperform those who rely on free quizzes and YouTube videos alone. Why? Because rationales teach you why each answer is right or wrong — they turn every missed question into a learning opportunity.
Whether you're facing the TEAS or the HESI, our practice PDFs are built to match the real exam — same format, same difficulty, same content distribution.
Download TEAS PDF Download HESI PDF
Not sure which exam your school requires? Message us on WhatsApp — we help nursing students every day and can point you in the right direction in under 60 seconds.