TEAS vs HESI: Which Nursing Entrance Exam Is Right for You in 2026?

If you're applying to nursing school, you've likely encountered two major entrance exams: the ATI TEAS and the HESI A2. Both are widely accepted by nursing programs across the United States, but they differ significantly in structure, content, difficulty, and scoring. Choosing the right one—or knowing how to prepare for whichever your school requires—can make a real difference in your application.

In this comprehensive comparison, we'll break down everything you need to know about the TEAS vs HESI exams so you can walk into test day fully prepared and confident.

What Is the TEAS Exam?

The Test of Essential Academic Skills (TEAS) is developed by Assessment Technologies Institute (ATI). It's a standardized exam with a fixed structure—every test-taker across the country completes the same four sections in the same order. The current version, TEAS 7, consists of 170 questions (150 scored, 20 unscored) across Reading, Mathematics, Science, and English and Language Usage, with a total time of 209 minutes.

What Is the HESI A2 Exam?

The Health Education Systems, Inc. Admission Assessment (HESI A2) is published by Elsevier. Unlike the TEAS, the HESI A2 is modular—nursing programs choose which sections their applicants must complete. This means the exam can vary significantly from school to school. Possible sections include Anatomy and Physiology, Biology, Chemistry, Grammar, Math, Reading Comprehension, Vocabulary, Physics, and even personality assessments.

TEAS vs HESI: Side-by-Side Comparison

Here's how the two exams stack up across the most important factors:

Exam Structure and Length

• TEAS: Fixed 170 questions, 209 minutes total. Four sections: Reading (45 questions, 55 min), Math (38 questions, 57 min), Science (50 questions, 60 min), English (37 questions, 37 min)
• HESI A2: Variable length depending on school requirements—can range from 50 to 326 questions. Typically 2-4 hours. Sections are chosen by each nursing program
• Key difference: The TEAS is standardized nationally, while the HESI varies by school

Question Types

• TEAS: Multiple-choice, select-all-that-apply, fill-in-the-blank, ordered response, and hot spot (image-based) questions
• HESI A2: Primarily multiple-choice questions only
• Key difference: The TEAS has more diverse question formats, which requires additional preparation strategies

Content Focus

• TEAS: Focuses on general academic readiness with balanced coverage across reading comprehension, foundational math, life sciences, and grammar
• HESI A2: Tends to be more medically specific, with deeper science questions and separate sections for anatomy, biology, and chemistry
• Key difference: Students with strong science backgrounds may find the HESI science sections more familiar, while the TEAS tests broader academic skills

Difficulty Level

Many students consider the HESI A2 to be more challenging overall, primarily because of its more specialized science content and the potential for a wider range of topics. The TEAS is often perceived as more approachable since it focuses on generalized academic skills rather than deep medical knowledge.

However, difficulty is subjective. If you haven't studied math in years, the TEAS math section might feel harder. If you're currently taking anatomy courses, the HESI science sections could feel manageable. Your personal academic background plays a major role.

Scoring Systems

• TEAS: Scores reported as percentages (0-100%) for composite and each section. ATI categories range from Developmental (below 40.7%) to Exemplary (92-100%). Most competitive programs seek 70%+ composite scores
• HESI A2: Scores on a scale of 0-100%. Most nursing schools require 75-80%+ to be competitive. Some programs set minimum scores for individual sections
• Key difference: Both use percentage-based scoring, but nursing schools set their own minimum thresholds for each exam

Cost Comparison

• TEAS: Typically $60-$140 depending on testing location. Additional $27 per extra score report sent to schools
• HESI A2: Generally $50-$100, making it slightly cheaper than the TEAS in most cases
• Key difference: The HESI tends to be $10-$40 cheaper, but costs vary by institution

Testing Options

• TEAS: Can be taken in-person at a testing center or institution, OR remotely online with a webcam and microphone through ATI's remote proctoring
• HESI A2: Generally requires in-person testing at a testing center or the nursing school campus
• Key difference: The TEAS offers more flexibility with its remote testing option

Retake Policies

Both exams allow retakes, but the policies differ:

• TEAS: ATI requires a minimum 14-day waiting period between attempts. Many schools enforce 30-60 days. Most programs limit retakes to 2-3 per year
• HESI A2: Retake policies are entirely school-specific. Some allow 2 attempts per year, others may allow more. Waiting periods vary
• Key difference: The TEAS has a clearer national retake framework, while HESI policies are entirely institution-dependent

Which Schools Require Which Exam?

There's no universal rule—each nursing program decides which exam to accept. Generally speaking, both ADN (Associate Degree in Nursing) and BSN (Bachelor of Science in Nursing) programs may require either exam. Some schools accept both and let applicants choose. Always check your target program's admissions page for their specific requirements.

If you're applying to multiple schools, you may need to prepare for both exams. The good news is that the content overlaps significantly—strong skills in reading, math, science, and English will serve you well on either test.

How to Prepare for the TEAS

Since the TEAS is standardized, your preparation can follow a structured plan. ATI recommends a minimum of 6 weeks for comprehensive study. Focus on all four sections with extra time allocated to Science (the largest section with 50 questions) and your weakest areas.

• Take a diagnostic practice test to identify weak areas before creating your study plan
• Use a structured week-by-week study schedule covering all four sections systematically
• Practice with full-length 170-question exams under timed conditions to build stamina
• Focus extra time on the Science section, which has the most questions and content to memorize
• Review math formulas and grammar rules through flashcards and quick-reference sheets

Final Verdict: TEAS or HESI?

The exam you take ultimately depends on your target nursing school's requirements. If you have a choice, consider these factors: the TEAS offers a standardized, predictable format with remote testing options, making preparation more straightforward. The HESI may be slightly cheaper but requires more tailored preparation since sections vary by school.

Regardless of which exam you take, the preparation fundamentals are the same: start early, use quality study materials, take practice tests, and focus on your weaknesses. Your dedication to preparation matters far more than which specific exam you're taking.