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Published On Apr 29, 2025

Health Education Systems Incorporated (HESI) creates standardized exams for nursing and healthcare programs. The HESI exam is a standardized test designed to assess the academic readiness of potential nursing students.¹

The HESI Exit Exam is administered during the final semester of nursing school. This exam assesses students’ preparedness for the NCLEX-RN or NCLEX-PN exams, which are required for nursing licensure. The HESI Exit Exam is a comprehensive test that helps identify areas where students may need further study prior to taking the NCLEX.

These exams are crucial for ensuring that nursing students have the necessary knowledge and skills to succeed in their education and future careers.¹

Why Are HESI Exams Valuable?

HESI exams provide valuable insights into students' strengths and weaknesses, allowing for targeted remediation.² Remediation is offered for each exam, customized to the student’s own performance.²The exams' predictive validity and detailed performance reports help educators identify areas where the curriculum may need adjustment to better prepare students for the NCLEX.³ Frequent exposure to proctored HESI exams and NCLEX-style questions can help students become more comfortable with the testing environment and question format, which can ultimately improve their performance on the NCLEX.⁴ Studies have shown that students who perform well on HESI exams are more likely to pass the NCLEX on their first attempt.⁵

HESI Test Prep

Preparing for the HESI exam requires focused study and effective strategies. Here are some that may be helpful.

Review Materials

Although there are many review books on the market for NCLEX content review and practice questions, it would be most beneficial to go directly to the source if you are studying for a particular exam. HESI offers the HESI Comprehensive Review for both RN and PN NCLEX. This is a textbook and a question bank to aid in preparation for HESI nursing exams.⁶ A review book for this purpose should contain high-level content and quiz questions.

Application-Level Learning

Utilize case studies, virtual simulations and scenario-based learning. It is not enough to know and understand the content; you must also be able to compare, assign priority, recognize urgency and make decisions. Your studies should prepare and challenge you for this level of exam question type.

Exam Design

HESI exams are designed to emulate the NCLEX exam. This means the exam is computerized and the test-taker sees only one question at a time; after hitting “submit,” they cannot revisit that question. Question styles will include any format seen on the NCLEX exam. HESI nursing exams now have Next Generation NCLEX-style questions. There is another very useful resource published by HESI to help students understand these new item formats.⁷

Manage the Exam

Practice answering quiz questions for the number of questions you will face on the exam. While quizzing, create an environment similar to the one you will experience during the exam. This may include:

Using a quiet space
Completing your quiz in exam mode with only one question at a time — no backtracking and no answers until the end
Practicing good testing habits

Notice those tendencies you have that are less effective — such as changing your answers, sitting too long on a question or skimming the question without reading it entirely. Take steps to let those tendencies go. This takes practice, self-awareness and sometimes help from a faculty member.

Remember that in an exam, all you must do is answer the question in front of you. Read it thoroughly, read all the options, select the best answer, submit and move on. Make sure you understand what the instructions are for the question. Ask yourself, what part of the solution is the question looking for?

Related Article: 4 Tips for Acing Your HESI Exam

HESI Exam Practice and Planning

If the exam is 75 questions, prepare with 75-question practice tests, taking time for mini mental breaks. Write affirmations for exam day and practice them while completing practice tests. What will you do during your mental break? Practice that. Quizzing the topics for the exam will also expose you to topics you may see. Review the questions you got wrong and identify why. Do you need to study that topic more? Did you discover a new testing tendency you need to let go of (changing your answers, for example)?

Many testers struggle with question regret. The last question answered hangs with the tester as they read the next one. This can color how you answer the next several questions. Practice letting go. Why not assume you got the question right and say “Next!” to yourself as you click “submit”? Negative self-talk can become a barrier to finding the correct answer and may lead to doubt, doom and downward spiraling of your confidence. This doubt could continue to cloud your judgment when answering subsequent questions.

Exam Day

Know yourself and what you need to keep your spirits up and your head clear. If you have followed your HESI Exam practice plan, including practice tests, you should be on your way to having a decent exam experience.

Here are some tips for what to do and not do just before an exam.

Explore GCU Resources for HESI and NCLEX

In conclusion, preparing for the HESI and NCLEX exams requires a strategic approach that includes targeted remediation, application-level learning and effective exam management. When you enroll in GCU's pre-licensure nursing program, we will help you prepare for HESI exams and NCLEX. Utilizing resources like the HESI Comprehensive Review and practicing quizzing with NCLEX-style questions can enhance your readiness. Remember that consistent practice and a positive mindset are key to passing your nursing exams.

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Written By

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Amy Leach

NCLEX Success Director, College of Nursing and Health Care Professions

College of Nursing and Health Care Professions

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¹ Elsevier. (n.d.). HESI Exam Solutions: Nursing Specialty Exams. Retrieved March 25, 2025.

²Regan, K., Thomas, R., Bradley, H., Willmus, N., Donahue, R. J., Olsen, J., Wildenberg, C. & Mota, D. (2022, May). HESI Standardized Nursing Exam Remediation: A Program Evaluation Project. University of Wisconsin-Eau Claire. Retrieved March 25, 2025.

³ Morrison, S., Adamson, C., Nibert, A. & Hsia, S. (2008). HESI Exams: An Overview of Reliability and Validity. Nurse Educator, 33(5), 39S-45S. doi:10.1097/01.NCN.0000336442.01671.c6. Retrieved March 25, 2025.

⁴ Shah, M., Fuller, B., Gouveia, C., Mee, C. L., Baker, R. S. & San Pedro, M. O. Z. (2022). NCLEX-RN Readiness: HESI Exit Exam Validity and Nursing Program Policies. Journal of Professional Nursing, 39, 131-138. Retrieved March 25, 2025.

⁵ Langford, R. & Young, A. (2013). Predicting NCLEX-RN Success With the HESI Exit Exam: Eighth Validity Study. Journal of Professional Nursing, 29(S5-S9). Retrieved March 25, 2025.

⁶ HESI. (2022). HESI Comprehensive Review for the NCLEX-RN Examination (7th ed.). Elsevier. Retrieved March 25, 2025.

⁷ Elsevier. (n.d.). Next Generation NCLEX^® (NGN) Item Types. Retrieved March 25, 2025.

Approved by the dean of the College of Nursing and Health Care Professions on April 15, 2025.

Why Are HESI Exams Valuable?