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HESI A2 Grammar: What the 50-Question Exam Covers and the Rules That Matter Most
The HESI A2 Grammar exam has 50 scored questions on grammatical terms, common errors, and parts of speech. See what Elsevier says it covers, worked original examples, the error patterns to drill, and why grammar matters to some programs.
Short answer
The HESI A2 Grammar exam is one of the three English Language exams. Elsevier's 2022 A2 paper lists 50 scored items with an estimated 50 minutes, covering important grammatical terms and their uses, common grammatical errors, and parts of speech; your program decides whether you take it. Most points come from a handful of patterns: subject-verb agreement, pronoun case and agreement, verb tense and irregular forms, adjectives versus adverbs, and commonly confused words. Learn each rule, then practice spotting the error in a sentence rather than memorizing definitions.
Where Grammar fits on the HESI A2
Elsevier groups the A2's academic exams into English Language, Math, and Science. Grammar is one of the three English Language exams, alongside Reading Comprehension and Vocabulary and General Knowledge. Elsevier's 2022 paper on the A2 describes it this way:
| Detail | Grammar exam |
|---|---|
| What it covers | Important grammatical terms and their uses, common grammatical errors, and parts of speech |
| Scored items | 50 |
| Estimated time | 50 minutes |
| Score | A percentage score, which also feeds your composite |
Whether you take Grammar depends on your program. Central New Mexico Community College and Tarleton State University, for example, both list Grammar among their required sections, while some programs leave it out. The HESI A2 overview explains how programs choose exams. Elsevier's current review book, the 2024 sixth edition, has a dedicated Grammar chapter.
Why some programs care about grammar
Grammar can look like the easy section next to chemistry, but it shows up in admission research. In one study summarized in Elsevier's paper (Chen and Voyles, 2013, 506 associate-degree nursing students), students who succeeded in their first term had a higher average Grammar score than those who didn't: 86.33 versus 79.81. Nursing coursework depends on clear writing, from care plans to exam answers, so treat Grammar as more than the easy section. Once you know your weak patterns, practice HESI A2 Grammar questions with an explanation for each answer.
The patterns that decide most Grammar questions
Elsevier's description names three areas. In practice they break into a few recurring error types. These examples are original, not HESI items.
Subject-verb agreement. Find the true subject, skipping phrases between it and the verb.
- Wrong: The list of supplies are on the counter.
- Right: The list of supplies is on the counter. The subject is list, not supplies.
Pronoun case. Use the subject form (I, he, she, we, they) as a subject and the object form (me, him, her, us, them) after a verb or preposition.
- Wrong: The nurse gave the report to Maria and I.
- Right: The nurse gave the report to Maria and me. Test it by dropping "Maria and": gave the report to me.
Pronoun-antecedent agreement. A pronoun must match the noun it replaces in number.
- Wrong: Each of the vials had lost their label.
- Right: Each of the vials had lost its label. The antecedent is each, which is singular.
Verb tense and irregular verbs. Keep tense consistent and know irregular past forms.
- Wrong: She has went to the clinic twice.
- Right: She has gone to the clinic twice.
Adjective or adverb. Adjectives describe nouns; adverbs describe verbs, adjectives, or other adverbs.
- Wrong: The patient recovered quick.
- Right: The patient recovered quickly.
Commonly confused words. Affect/effect, their/there/they're, its/it's, than/then, lie/lay, fewer/less.
- Wrong: The medication had no affect on her pain.
- Right: The medication had no effect on her pain. (Affect is usually the verb; effect is usually the noun.)
A worked question (original)
Which sentence is grammatically correct?
- A. Neither the nurses nor the doctor were available.
- B. Neither the nurses nor the doctor was available.
- C. Neither the nurses or the doctor was available.
- D. Neither the nurses nor the doctor are available.
Answer: B. With neither...nor, the verb agrees with the nearer subject, doctor, so it's singular: was. A uses a plural verb, C pairs neither with or, and D shifts to present tense and uses a plural verb.
Parts of speech: what you need to name
Elsevier's description includes parts of speech, so expect a few questions that ask you to identify one. Make sure you can name a word's role in a sentence, not just in isolation:
| Part of speech | Job in the sentence | Example |
|---|---|---|
| Noun | Names a person, place, thing, or idea | The chart was updated. |
| Pronoun | Replaces a noun | She updated it. |
| Verb | Shows action or state | She updated the chart. |
| Adjective | Describes a noun or pronoun | The updated chart |
| Adverb | Describes a verb, adjective, or adverb | She updated it carefully. |
| Preposition | Shows a relationship, usually of place or time | The chart is on the desk. |
| Conjunction | Joins words or clauses | Check the chart and the order. |
The same word can change jobs: updated is a verb in one sentence and an adjective in another. Questions often test exactly that.
How to study Grammar in two weeks
- Diagnose. Take a short mixed set and sort your misses by the patterns above.
- Drill your top two patterns. Spend most of the first week on the two error types that cost you the most.
- Read your errors aloud. Many grammar errors sound wrong once you hear them.
- Mix it back in. Finish with mixed sets so you can spot the error without knowing which rule is being tested.
If one pattern keeps returning in your misses, focus your next sessions on the grammar errors you miss most. Grammar pairs naturally with vocabulary and reading comprehension, the other two English Language exams.
Trust the source
Official sources
Exam policies can change. Use these primary sources for the most current details.