Nursing school entrance exam: which test your program uses, and how to prepare
Most US nursing programs ask for one of two entrance exams: the ATI TEAS or the HESI A2. A smaller number use the NLN's Nursing Entrance Exam (NEX, which replaced the PAX in 2024), the Kaplan Nursing Admission Test, a PSB exam, ACCUPLACER, or an SAT or ACT score. You don't pick: your program names the test, the score it wants and how recent it must be, on its admission page.
This guide puts the exams side by side, shows which programs tend to use which, when the exam is waived, and how to prepare once you know yours.
Nursing entrance exams side by side
| Exam | Made by | What it tests | Length | Score |
|---|---|---|---|---|
| ATI TEAS (Version 7) | ATI Nursing Education | Reading, math, science, English and language usage | 170 questions, 209 minutes | Percent, total and per section; program sets the minimum |
| HESI A2 | Elsevier | The school picks sections: math, reading, vocabulary, grammar, anatomy and physiology; sometimes biology, chemistry, physics | Varies by school; Tarrant County College lists 5 hours | Percent per section; program sets the minimum |
| NLN NEX (formerly PAX) | National League for Nursing | Verbal, math and science | Check your school's page | Program sets the minimum |
| Kaplan Nursing Admission Test | Kaplan | Reading, math, writing, science, with critical thinking mixed in | 91 questions, up to 165 minutes (MSU Billings) | Program sets the minimum |
| PSB Health Occupations | Psychological Services Bureau | Academic aptitude, spelling, reading, natural sciences, vocational adjustment | Check your school's page | Scaled; UAFS's PN program asks for 200 |
| ACCUPLACER | College Board | Placement: arithmetic, reading, writing | Untimed, adaptive | Scaled; e.g. CCRI asks 65+ in Classic Arithmetic |
| SAT or ACT | College Board, ACT | General college readiness | 2–3 hours | Some programs accept it instead of the TEAS (Rasmussen: ACT 18–20) |
TEAS figures are ATI's (what is on the TEAS test). The others come from the school and maker pages in the sources; formats change, so your school's page is the one to trust. PSB section names are from PSB's description of the exam as schools publish it; length varies.
What is the nursing school entrance exam called?
There is no single one. "The nursing entrance exam" usually means the TEAS (Test of Essential Academic Skills) or the HESI A2 (HESI Admission Assessment), because those two cover most programs. When an admission page says "pre-admission test", "nursing admission test" or "entrance exam", look for the exam's name a line or two further down, or in the application checklist.
How to find out which exam your program wants
- Open the program's admission or selection criteria page, not the college home page. Search it for "TEAS", "HESI", "NEX", "PAX", "Kaplan" or "entrance".
- Write down five things: the exam, the minimum overall score, any section minimums, how many attempts count, and how old a score can be.
- Check where you can test. Some programs want the exam at their own testing center; others accept a remote or test-center sitting and a score sent to them. See proctored exams for nursing prerequisites.
- Applying to several programs? Make a table. If they all take the TEAS, one sitting may serve all of them, as long as each accepts a score sent from another location.
- Still unclear? Email the nursing admissions office with the program name and application term. It's a common question; they'll answer.
For TEAS programs, our program minimums list has what 56 nursing and allied health programs publish, each linked to its own page.
The ATI TEAS
The TEAS is the most widely used nursing entrance exam we found. It is the same exam for every program: 170 questions in four timed sections, 150 of them scored.
| Section | Questions | Minutes | Main content |
|---|---|---|---|
| Reading | 45 | 55 | Key ideas, craft and structure, integrating sources |
| Mathematics | 38 | 57 | Numbers and algebra, measurement and data |
| Science | 50 | 60 | Anatomy and physiology, biology, chemistry, scientific reasoning |
| English and language usage | 37 | 37 | Grammar, punctuation, spelling, vocabulary |
It costs $120 plus tax registered through ATI or PSI; schools that run their own sittings set their own price (how much the TEAS costs). There is no national pass mark. In our list of 43 programs that publish an overall minimum, the median is 62% and the range 58% to 75% (what TEAS score you need).
The TEAS is also the entrance test for many allied health programs (radiography, sonography, respiratory therapy, surgical technology), so the same score can count for more than one kind of application.
The HESI A2
Elsevier's HESI Admission Assessment is the other common one. The big difference: each school builds its own version from a menu of sections, so two HESI A2 programs can ask for different tests. Tarrant County College lists 55 questions each for reading, vocabulary, grammar and math, and 30 for anatomy and physiology; the University of Arizona counts math, reading, vocabulary and biology and asks for 75% across them. Schools also set their own fees: Grayson College lists $55 for five sections and Elmhurst $51 for three.
Programs do switch. WGU stops accepting the HESI A2 on September 1, 2026 and accepts the ATI TEAS for its prelicensure BSN instead (WGU). If your program accepts both, compare them in HESI A2 vs TEAS.
The NLN NEX (formerly the PAX)
The National League for Nursing replaced its Pre-Admission Exam (PAX) with the Nursing Entrance Exam (NEX), launched in February 2024 (NLN). Trident Technical College, for example, switched from the PAX to the NEX on June 1, 2024 (Trident Tech). If a program page or a prep book still says PAX, check whether the program now gives the NEX. Format and fee details are best taken from your school's page; Trident lists its own fees for sitting on site or remotely.
Kaplan, PSB and ACCUPLACER
- Kaplan Nursing Admission Test. MSU Billings lists 91 questions: reading 22 in 45 minutes, math 28 in 45, writing 21 in 45 and science 20 in 30, plus an untimed tutorial (MSU Billings).
- PSB Health Occupations Aptitude Exam. Seen mostly at practical nursing and technical college programs. The University of Arkansas Fort Smith's PN program asks for a score of 200 (UAFS).
- ACCUPLACER. A college placement test some PN programs use as the entrance test: Anoka Technical College uses arithmetic and reading (Anoka Tech); the Community College of Rhode Island asks for 65 or higher in Classic Arithmetic (CCRI).
Does the exam differ for LPN, ADN and BSN programs?
The exam is usually the same; the score it takes changes. A few patterns from the programs we've read:
| Program type | Common exams | TEAS minimums in our list |
|---|---|---|
| Practical or vocational nursing (LPN, LVN, PN) | TEAS, HESI A2, PSB, ACCUPLACER | 58% to 60% |
| Associate degree nursing (ADN, RN) | TEAS, HESI A2, Kaplan, NEX | 58.7% to 70%, median 62% |
| Bachelor's (BSN) | TEAS, HESI A2; some take SAT or ACT | 58.7% to 75%, median 68% |
| Accelerated BSN (second degree) | TEAS or HESI A2, sometimes waived | Varies; see waivers below |
The exam column is the pattern we saw on school pages, not a rule. One example of a school that sets different bars by level: Rasmussen accepts the HESI A2, TEAS, ACT or SAT, and its ACT minimums are 18 for practical nursing, 19 for the ADN and 20 for the BSN (Rasmussen). Harrisburg Area Community College asks for a TEAS of 70 for RN and 60 for LPN.
Can the nursing entrance exam be waived?
Sometimes, mostly for applicants who already hold a degree:
- Rasmussen skips the entrance exam for applicants with a conferred bachelor's degree or higher and a GPA of at least 2.25.
- UAMS's accelerated BSN exempts applicants whose degree is already conferred (UAMS).
- Kennesaw State's accelerated BSN still requires the TEAS, taken within 5 years (Kennesaw State).
So a degree may get you out of it, or may not; it's program by program. If the waiver isn't written on the admission page, assume you need the exam and ask before skipping it.
How to prepare for a nursing entrance exam
- Confirm the exam and the number first. Prep for the wrong exam, or for a 75% when your program needs 62%, wastes weeks.
- Take a timed practice test before studying. For the TEAS, our free TEAS practice test is 15 questions across the four sections, scored against your program's minimum.
- Size the plan from the gap. Above the minimum, a week or two of practice tests; more than 10 points short, six to eight weeks (how long to study for the TEAS).
- Study by answering questions, section by section, weakest first, and keep a log of every miss.
- Finish with full timed tests. Each TEAS section has its own clock; pacing is part of the score (TEAS test taking strategies).
Science is where most applicants lose points on both the TEAS and the HESI A2, and anatomy and physiology is the biggest science block on both. Start with TEAS anatomy and physiology and TEAS biology.
What nursing entrance exam questions look like
Every exam above is mostly multiple choice at a high school level, with a nursing twist in science. On the TEAS you'll also see select-all-that-apply, fill in the blank, ordered response and hot spot questions, scored right or wrong with no partial credit. To see real-style questions with answers explained, try our TEAS sample questions, or the section sets: math, science, reading and English.
Retakes and how long a score lasts
The test maker rarely sets the limit; the program does. ATI sets no waiting period between TEAS attempts and leaves attempt limits to schools, and every completed TEAS counts as an attempt even if you don't send the score (ATI). For the HESI A2, Tarrant County College allows one test per application period, with attempts at least 60 days apart; Elmhurst allows one attempt. Score age rules range from one year to five (Kennesaw State's ABSN). Our TEAS retake guide lists 25 programs' rules.
Nursing school entrance exam FAQ
Do all nursing schools require an entrance exam?
Most pre-licensure programs do, but not all, and some waive it for applicants with a bachelor's degree. Check the program's admission page.
Which nursing entrance exam is easiest?
None is easy or hard for everyone. The HESI A2 varies with the sections your school picks; the TEAS is fixed and science-heavy. If your program accepts both, take the one whose sections match your strengths (HESI A2 vs TEAS).
Is the TEAS the same as the nursing entrance exam?
For many programs, yes: the TEAS is the entrance exam they name. Others use the HESI A2, NEX or another test.
Is the PAX still used?
The NLN replaced the PAX with the NEX in 2024. A program still listing the PAX may have switched; ask.
Can one TEAS score count for several programs?
Often, if each program accepts a score taken elsewhere and you send it to each one through ATI. Some programs require their own sitting.
How long does it take to get results?
For the TEAS, scores usually post soon after you finish when taken online or at PSI; school sittings can take longer (TEAS test results). Tarrant County College lists 48 to 72 hours for HESI A2 results.
Sources
- ATI, TEAS exam details; How many times can I take the ATI TEAS?
- Elsevier, HESI exam solutions for nursing.
- Tarrant County College, HESI A2 exam information; University of Arizona, HESI Admission Assessment.
- WGU, HESI Admissions Assessment. Read 2026-11-04.
- Grayson College, ADN HESI overview 2024; Elmhurst University, Nursing admission exam information.
- National League for Nursing, NEX assessment; Trident Technical College, Nursing entrance testing.
- MSU Billings, Kaplan admission test information.
- University of Arkansas Fort Smith, PN application packet; Anoka Technical College, PN admissions guidelines; CCRI, Practical nursing diploma.
- Rasmussen University, Nursing entrance exam. Read 2026-11-04.
- UAMS, Accelerated BSN; Kennesaw State, Accelerated BSN.
- TEAS minimums by program type: our list in what TEAS score you need (HACC's RN and LPN minimums among them).
More: what is on the TEAS test, can you use a calculator on the TEAS, TEAS unscored questions, HESI A2 vs TEAS, is there a new TEAS, or all TEAS guides. If your program takes the TEAS, take the free TEAS practice test to see where you stand against its minimum.