The HESI Anatomy & Physiology (A&P) section is one of the most important parts of the HESI A2 exam.
Students often say:
- “Math was predictable.”
- “Reading was manageable.”
- “But Anatomy & Physiology was hard.”
The reason?
The HESI A&P section tests applied physiological understanding - not memorization of definitions.
If you haven’t reviewed the overall structure of the exam yet, begin with our complete HESI A2 exam breakdown and section guide so you understand how A&P fits into your total score.
This guide will cover:
- How many questions are on the HESI A&P section
- Exactly what topics are tested
- Why the section feels difficult
- What a good A&P score is
- How to improve your score quickly
- High-yield study strategies
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How Many Questions Are on the HESI Anatomy & Physiology Section?
Most versions of the HESI A2 Anatomy & Physiology section include:
- 25–30 multiple-choice questions
- Section-specific time limits
- Percentage-based scoring
Because the section contains relatively few questions, every question carries weight.
Missing just 5 questions on a 25-question section drops you to 80%.
That’s why precision matters.
What Is Tested on the HESI A&P Section?
The HESI A&P section focuses on:
- Structure-function relationships
- Basic physiological regulation
- System interactions
- Homeostasis
- Cause-and-effect reasoning
It does NOT test:
- Advanced pathology
- Detailed medical diagnoses
- Rare disorders
Instead, it tests foundational nursing knowledge.
High-Yield Systems You Must Master
Below are the systems most commonly tested and what you should know about each.
1. Cardiovascular System
You should understand:
- Blood flow through the heart
- Oxygenated vs deoxygenated pathways
- Cardiac output basics
- Blood pressure regulation
- Effects of hemorrhage
Common question style:
“If cardiac output decreases, what happens to blood pressure?”
This requires understanding functional consequences.
2. Respiratory System
High-frequency concepts:
- Gas exchange in alveoli
- CO₂ retention
- Oxygen transport
- Effects of hypoventilation
- Acid-base balance basics
Example concept:
Hypoventilation → CO₂ retention → respiratory acidosis.
3. Renal System
Students often underestimate renal questions.
Expect:
- Filtration and reabsorption basics
- Fluid balance
- Electrolyte regulation
- Renin-angiotensin system basics
Renal interacts heavily with cardiovascular regulation.
4. Nervous System
You should know:
- CNS vs PNS roles
- Sympathetic vs parasympathetic
- Basic reflex pathways
- Neurotransmitter function
Questions may test stimulus-response patterns.
5. Endocrine System
Focus on:
- Hormone feedback loops
- Insulin vs glucagon
- Thyroid regulation
- Stress response hormones
Hormonal balance is frequently tested.
For every organ system, ask: “If this system fails, what happens next?” HESI frequently tests consequences rather than definitions.
Why Is the HESI A&P Section Hard?
Students struggle because:
- They memorize anatomy terms without understanding physiology
- They study systems in isolation
- They don’t practice applied questions
Unlike math (which is procedural), A&P requires conceptual thinking.
If you need structured pacing, integrate A&P study into our full 30-day HESI study plan for admissions and Exit exams.
Sample HESI A&P Question Breakdown
Example 1
A patient experiences blood loss. What is the body’s immediate compensatory response?
A. Decreased heart rate
B. Increased vasodilation
C. Increased heart rate
D. Reduced oxygen delivery
Correct answer: C
Reasoning: Blood loss lowers blood pressure → sympathetic activation → increased heart rate.
Notice: The question tests physiology under stress — not memorization.
Example 2
If aldosterone increases, what happens to sodium levels?
Correct reasoning: Aldosterone promotes sodium retention → increases blood volume.
These are cause-and-effect patterns.
What Is a Good HESI A&P Score?
Many programs require:
- 75–80% minimum
- 85%+ for competitive applicants
Because A&P heavily impacts composite scores, improving this section can significantly raise your overall average.
Review our explanation of what counts as a strong HESI score for admissions to determine your target.
How to Raise Your HESI A&P Score
Step 1: Study by System
Do not jump randomly between topics.
Master:
- Cardiovascular → Respiratory → Renal cluster first
These systems frequently interact.
Step 2: Focus on Functional Relationships
Understand:
- Regulation
- Compensation
- Feedback loops
Avoid pure memorization.
Step 3: Practice Applied Questions
Application improves retention.
Step 4: Use Adaptive Review
Structured adaptive tools inside our HESI exam prep platform for nursing applicants help identify weak systems automatically.
Studying A&P using flashcards only. Without applied reasoning practice, knowledge does not translate to higher HESI scores.
How Long Should You Study for HESI A&P?
Most students benefit from:
- 2–3 weeks of focused review
- 30–45 minutes daily
- System-based practice
If A&P is your weakest area, extend study time before focusing on other sections.
Frequently Asked Questions
Is the HESI A&P section harder than math?
For many students, yes — because it tests reasoning instead of calculation.
How many A&P questions are on the HESI?
Typically 25–30 questions.
Does HESI test lab values?
Basic understanding may appear in context, but detailed memorization is not required.
Is HESI A&P harder than TEAS science?
HESI is deeper in A&P; TEAS is broader across science topics.
Final Takeaway
The HESI Anatomy & Physiology section rewards:
- Functional understanding
- Cause-and-effect reasoning
- System interaction knowledge
It does not reward memorization alone.
If you strengthen cardiovascular, respiratory, and renal concepts, you significantly increase your chances of scoring 85%+.
Consistent, system-based practice makes the difference.
