Nursing entrance exams explained: TEAS, HESI A2, and the rest

A nursing entrance exam is an admissions test your program uses to check academic readiness before it offers you a seat, and the single most useful fact about them is this: you do not choose which one to sit. Your program does. In US admissions two exams dominate, the ATI TEAS and the HESI A2, and a handful of alternatives appear at particular schools. So the job is not to survey the whole field. It is to find the one name on your program's admissions page and prepare for exactly that.

The field at a glance

Exam	Publisher	Shape
TEAS 7	ATI	One standardised exam: Reading, Mathematics, Science, and English. 170 questions in 209 minutes, the same for everyone.
HESI A2	Elsevier	A modular kit of eight subtests. Your program picks the list, commonly the four academic subtests plus chosen sciences.
PAX	NLN	Verbal, mathematics, and science sections. Found at a smaller set of programs, often long-established ones.
Kaplan admissions test	Kaplan	Reading, writing, mathematics, and science. Used by a minority of programs.
PSB aptitude exams	PSB	A family of health-occupations exams covering academic aptitude, science, and vocational readiness. Mostly at diploma and allied-health programs.

The TEAS is the most widely required of the five, with the HESI A2 its main rival, so if you are preparing before you have shortlisted schools, the odds strongly favour one of those two.

TEAS and HESI A2: the two you will most likely meet

The deep difference between the front-runners is philosophy. ATI ships one fixed TEAS: every applicant sits the same four sections on the same clocks, which makes scores directly comparable across schools. Elsevier ships the HESI A2 as a kit, and each program assembles its own exam from the eight subtests, so two applicants can sit genuinely different HESI A2s.

Same destination. Both exams sample high-school-level reading, mathematics, language, and science. Preparing for one builds most of what the other asks.

That difference decides your first preparation step. For the TEAS you can start immediately, because the exam's shape is public and fixed: see what is on the TEAS test. For the HESI A2 you must first learn your program's subtest list, because it defines your exam: see what is on the HESI A2 exam. For a decision-level comparison of the two, our TEAS vs HESI guide goes format by format.

The alternatives, briefly

If your program names the PAX, the Kaplan test, or a PSB exam, the same logic applies at a smaller scale: get the program's own description of the sections and its required score, and prepare against that page rather than against general advice. These exams publish less public detail than the big two, which makes the program's information packet your primary source. Confirm the format, the timing, and the booking route with the admissions office directly, and be wary of third-hand section lists from forums, which age badly.