HESI specialty exams are Elsevier’s course exams, one subject at a time, and the HESI Exit (E2) is the end-of-program one. Both are scored on a scale that usually runs from 0 to 1,500. Elsevier calls 850 acceptable and 900 recommended, and schools set their own targets. Each exam comes with remediation built from your weakest areas.
Not the entrance exam: the HESI A2 for getting into nursing school is a different test. See what the HESI A2 is.
Which HESI exams there are
Elsevier says specialty exams exist for 15 RN areas, including Fundamentals, Medical-Surgical, Pharmacology, Maternity, Pediatrics, Psychiatric/Mental Health, Community Health, Management, Critical Care, Gerontology, Health Assessment and Pathophysiology, plus combined exams such as Maternity/Pediatrics. Each has parallel versions, so a retake is a different form.
The score, 850 vs 900, and conversion scores
- The HESI score comes from Elsevier’s scoring model, which weighs how hard each question is as well as whether you got it right. Next-generation items earn partial credit.
- 850 is “acceptable”, 900 “recommended” (Elsevier).
- Conversion score: for RN exams given after February 15, 2024, the HESI score times 0.09 (850 → 76.5, 900 → 81). Many schools use their own chart instead: Wright State divides by 10, and BYU-Idaho maps 900–949 to 90%.
On the exit exam, Elsevier’s 2023 study of 708 students at 20 programs found 96% of students scoring 850 or higher passed the NCLEX on the first try (Elsevier). Elsevier also reports that students who took more specialty exams scored higher on the exit exam, a link rather than proof of cause.
A ready-made plan for each HESI exam
HESI Fundamentals
Covers safety, infection control, assessment, basic care, nutrition, med administration and the legal basics. Start the HESI Fundamentals plan.
HESI Medical-Surgical
Covers every body system, plus fluids and electrolytes and perioperative care. Start the HESI Med-Surg plan.
HESI Pharmacology
Covers every drug class by body system, plus med safety and dosage calculation. Start the HESI Pharmacology plan.
HESI Maternity
Covers pregnancy, labor and birth, postpartum, the newborn and OB meds. Start the HESI Maternity plan.
HESI Pediatrics
Covers growth and development, childhood illness by system, immunizations and pediatric meds. Start the HESI Pediatrics plan.
HESI Psychiatric/Mental Health
Covers therapeutic communication, the major disorders, safety and the psych meds. Start the HESI Mental Health plan.
HESI Community Health
Covers public health, disaster and emergency preparedness, and communicable disease. Start the HESI Community Health plan.
HESI Management/Leadership
Covers prioritization, delegation, ethics and legal, and quality and safety. Start the HESI Leadership plan.
HESI Exit (E2)
Covers the whole NCLEX test plan. Start the plan, which begins on our highest-yield NCLEX topics, and take our free full-length NCLEX practice test.
Ready-made study plan
HESI Med-Surg, week by week
186 NurseSavvy topics across 11 areas. About 16 topics a study day, six days a week, then a week of mixed practice.
Week 1 · 100 topics
Fluid, Electrolyte & Acid-Base · Cardiovascular · Respiratory · Neurological
Week 2 · 86 topics
Gastrointestinal · Renal & Urinary · Endocrine · Musculoskeletal · Hematological & Oncology · Integumentary & Burns · Perioperative Nursing
Week 3 · mixed practice
Questions across every area, a timed practice test early in the week, then only the topics you missed. Nothing new the night before.
How to study for a HESI specialty exam
- Measure first. Use the practice your school assigned through Evolve (case studies, practice tests, adaptive quizzing) as a map of what you missed, not a forecast.
- Fix the misses, not the whole book. Work the remediation packets HESI builds from your weakest areas before any retake version.
- Relearn by system, then mix. Learn each weak area with short recall sessions (on NurseSavvy, the topic’s cards and cheat sheet), then answer mixed questions so you practice choosing the area, not just answering inside it.
- Spend the last days on priority and safety. These exams are written in the NCLEX style: what do you do first, which finding do you report, what does the teaching need to correct. Our priority-question guide covers the reasoning.
- Stop the night before. Sleep is the last study session.
Sources: Elsevier’s HESI score explainer, 2023 score-setting study, specialty exam best practices and specialty-to-exit study, and the HESI policies of BYU-Idaho, Wright State and Morehead State. Read October 24, 2026.
ATI, Content Mastery Series and Comprehensive Predictor are trademarks of Assessment Technologies Institute, LLC. HESI is a registered trademark of Elsevier. Kaplan is a trademark of Kaplan, Inc. NCLEX is a registered trademark of the National Council of State Boards of Nursing. NurseSavvy is not affiliated with or endorsed by these companies, and every NurseSavvy practice question is original.
Common questions
What is a good HESI score?
On HESI specialty and exit exams, Elsevier calls 850 the acceptable benchmark and 900 the recommended one. Scores usually range from 0 to 1,500. Your school sets its own target.
What is a HESI conversion score?
A percent-style score made from your HESI score for the gradebook. For RN exams given after February 15, 2024, Elsevier’s conversion score is the HESI score times 0.09, so 900 becomes 81. Many schools use their own chart instead.
Does a high HESI Exit score mean I will pass the NCLEX?
It is a strong signal, not a guarantee. In Elsevier’s 2023 study of 708 students at 20 programs, 96% of those scoring 850 or higher on the RN exit exam passed the NCLEX on the first try.
Can I retake a HESI specialty exam?
Elsevier makes parallel versions and recommends offering Version 2 to students who miss the target, after remediation. Whether you can retake is your school’s rule.