Nursing entrance tests typically cover four core areas: math, reading comprehension, science, and English language skills. The exact subjects depend on which exam your program requires, but the most widely used tests (the TEAS, HESI A2, and NLN PAX) all assess whether you have the academic foundation to handle nursing coursework. Knowing what’s on each test lets you focus your study time where it counts.
The Three Main Nursing Entrance Exams
Most nursing programs in the United States require one of three standardized tests for admission. The TEAS (Test of Essential Academic Skills), published by ATI, is the most common. The HESI A2 (Health Education Systems Admission Assessment) is the second most popular, particularly at BSN programs. The NLN PAX (National League for Nursing Pre-Admission Exam) is less common but still used by some associate degree and diploma programs.
Your nursing school’s admissions page will tell you which one they require. Some schools accept more than one, but you generally only need to take the specific test your program asks for. Each exam covers similar ground with slightly different emphasis and format.
What’s on the TEAS
The ATI TEAS has 170 questions and a time limit of 209 minutes (about 3.5 hours). It’s divided into four sections, each weighted differently in your overall score.
- Reading (45 questions, 55 minutes): Passages followed by comprehension questions. You’ll need to identify main ideas, make inferences, distinguish between fact and opinion, and interpret charts or graphs embedded in text. Some questions test your ability to follow written instructions or evaluate an author’s argument.
- Math (38 questions, 57 minutes): Arithmetic with whole numbers, fractions, decimals, and percentages. You’ll also see questions on ratios, proportions, measurement conversions (metric and standard), and basic algebra. Word problems that mimic real-world calculations are common. No calculator is provided for some questions, so mental math skills matter.
- Science (50 questions, 60 minutes): Human anatomy and physiology make up the largest chunk. Expect questions on body systems, particularly cardiovascular, respiratory, digestive, and nervous systems. The section also covers basic biology (cell structure, genetics, metabolism), chemistry (atoms, chemical bonds, solutions, pH), and scientific reasoning.
- English and Language Usage (37 questions, 37 minutes): Grammar, sentence structure, punctuation, spelling, and vocabulary in context. You’ll need to identify errors in sentences, choose the correct word for a given context, and demonstrate understanding of how paragraphs are organized.
Most nursing programs set a minimum composite TEAS score somewhere between 60% and 80%, though competitive programs often expect scores in the mid-70s or higher. Some schools weight certain sections more heavily, particularly science and math.
What’s on the HESI A2
The HESI A2 is modular, meaning your nursing program chooses which sections you need to take. Most programs require between four and eight sections. The full exam can take up to five hours, but your actual testing time depends on the combination your school selects.
- Math (55 questions, 50 minutes): Focuses heavily on dosage-relevant skills: fractions, decimals, ratios, proportions, and unit conversions. You’ll also see basic algebra and percentages. A built-in calculator is available for this section.
- Reading Comprehension (55 questions, 60 minutes): Similar to the TEAS but tends to use health-related passages. Questions cover identifying the main idea, drawing conclusions, finding supporting details, and determining the meaning of words in context.
- Vocabulary and General Knowledge (55 questions, 50 minutes): Tests your familiarity with common English vocabulary, including words frequently used in healthcare settings. These aren’t highly technical medical terms, but words like “bilateral,” “chronic,” or “void” that appear regularly in nursing contexts.
- Grammar (55 questions, 50 minutes): Parts of speech, subject-verb agreement, pronoun usage, comma placement, and sentence clarity. Straightforward if you have solid writing skills.
- Anatomy and Physiology (30 questions, 25 minutes): Covers all major body systems. Questions tend to be more detailed than the TEAS science section, asking about specific organ functions, locations, and how systems interact.
- Biology (30 questions, 25 minutes): Cell biology, photosynthesis, cellular respiration, genetics, and basic molecular biology.
- Chemistry (30 questions, 25 minutes): The periodic table, chemical reactions, balancing equations, acids and bases, and properties of matter.
- Physics (30 questions, 25 minutes): Less commonly required, but some programs include it. Covers basic mechanics, energy, waves, and electrical circuits.
HESI scores are reported as percentages for each section. Most programs want at least 75% to 80% on each required section, and some set an even higher bar for competitive admission.
What’s on the NLN PAX
The NLN PAX is shorter and more straightforward than the other two. It has 160 questions and takes about three hours. It’s divided into three sections with no modular options.
- Verbal Ability (60 questions, 40 minutes): Word knowledge and reading comprehension. You’ll match words to definitions, identify synonyms and antonyms, and answer questions about short passages.
- Math (40 questions, 40 minutes): Basic arithmetic, algebra, geometry, conversions, and data interpretation. The math tends to be slightly more broad than the TEAS or HESI, dipping into topics like basic geometry that the other tests skip.
- Science (60 questions, 40 minutes): A mix of biology, chemistry, physics, and earth science. The science section is more general than the HESI A2, covering a wider range but with less depth on any single topic.
NLN PAX scores are reported as percentiles rather than simple percentages, so your score reflects how you performed compared to other test-takers nationally.
Subjects That Matter Most
Across all three exams, anatomy and physiology, math involving fractions and dosage calculations, and reading comprehension carry the most weight for nursing admissions. These directly predict how well you’ll handle pharmacology courses, clinical documentation, and understanding how the body responds to disease and treatment.
Science is where most students spend the bulk of their study time, and for good reason. The anatomy and physiology content on these exams mirrors what you’ll encounter in your first semester of nursing school. If you’re solid on the major body systems (how blood flows through the heart, how oxygen gets exchanged in the lungs, how the kidneys filter waste), you’re well-positioned for the science sections on any of the three tests.
Math trips up students who haven’t worked with fractions and ratios recently. The questions aren’t advanced, but they require accuracy. A nursing dosage error in real life can be dangerous, so programs want to see that you can handle precise calculations without making careless mistakes.
How to Find Out Your Specific Test Content
Check your nursing program’s admissions page first. It will list which exam is required and often which sections (particularly relevant for the HESI A2’s modular format). ATI, HESI, and NLN all publish official study guides and practice tests that mirror the actual exam format. Starting with an official practice test is the fastest way to identify your weak areas before committing hours to a study plan.
Most students spend four to eight weeks preparing, focusing on one or two subject areas where their practice scores are lowest. If you’ve taken prerequisite courses in anatomy, biology, and chemistry within the past year or two, you may need less review for the science sections and can redirect that time toward math or reading speed.