What the section covers
TSTC's HESI A2 guide lists parts of speech, subject-verb and pronoun-antecedent agreement, dialogue and quotation marks, capitalization, and punctuation from commas to hyphens. Other school guides, such as Sandhills Community College's, add important grammar terms and commonly occurring errors. See every topic on the HESI A2 Grammar page.
1. Subject-verb agreement
Find the real subject and ignore phrases between it and the verb. Words like each, everyone, and neither are singular. Two subjects joined by and are plural; with or/nor, the verb agrees with the closer subject.
Choose the verb that correctly completes the sentence: "Each of the nurses ______ a badge."
2. Pronoun case
Use subject pronouns (I, he, she, we, they, who) as subjects and object pronouns (me, him, her, us, them, whom) after verbs and prepositions. Quick test: drop the other person. “Maria and me went” becomes “me went,” which is clearly wrong.
Which sentence is grammatically correct?
3. Commonly confused words
- affect / effect: affect is usually the verb (to influence); effect is usually the noun (a result).
- their / there / they're: belonging to them / a place / they are.
- its / it's: belonging to it / it is.
- than / then: comparison / time.
- accept / except: to receive / leaving out.
- lie / lay: to recline (no object) / to put something down (takes an object).
Which word correctly completes the sentence? "The new medication had no ______ on her blood pressure."
4. Pronoun-antecedent agreement
A pronoun must match the noun it replaces in number, and it must be clear which noun that is. “When the nurse called the patient, she was upset” is unclear: who was upset? Rewrite so only one reading is possible.
5. Verb tense and irregular verbs
Keep tense consistent within a sentence unless the time really changes. Know the common irregular forms: lie, lay, lain; lay, laid, laid; go, went, gone; see, saw, seen.
6. Punctuation
- Use a comma before and, but, or, so when it joins two complete sentences.
- A semicolon joins two complete sentences without a conjunction.
- A colon introduces a list or explanation after a complete sentence.
- Possessives: the patient's chart (one patient), the patients' charts (several).
How to study Grammar
- Learn one rule at a time with its quick test, then answer five questions on it from memory.
- Mix the rules once each is familiar; the real section jumps between them.
- When you miss one, write the rule's name next to it in your error log.
- Read the sentence with each choice in your head, but decide by the rule, not the sound.
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Common questions
What is on the HESI A2 Grammar section?
Parts of speech, subject-verb agreement, pronoun case and agreement, verb tense, commonly confused words (affect/effect, their/there), plurals and possessives, punctuation, and clear sentence structure.
How many grammar questions are on the HESI A2?
Usually 55 (50 scored) in about 50 minutes.
Is HESI A2 grammar hard?
The section keeps returning to a handful of rules you can learn quickly. The trap is picking the answer that sounds right. Name the rule being tested before you choose.
Do all schools require HESI A2 Grammar?
No. Grammar is often required, but not always. Check your program’s list of required sections.