ATI vs HESI: Which Nursing Exam is Harder and How to Prepare for Both

What Are ATI and HESI?

ATI (Assessment Technologies Institute) and HESI (Health Education Systems Incorporated) are standardized testing systems used by nursing programs to assess student knowledge and predict NCLEX success.

ATI Overview

ATI is used by approximately 1,500 nursing programs. It includes proctored exams for individual subjects and the ATI Comprehensive Predictor taken near graduation. ATI uses a proficiency level system: Level 1 (below proficiency), Level 2 (proficient), Level 3 (advanced). Most programs require Level 2.

HESI Overview

HESI exams are published by Elsevier. The HESI A2 is used for nursing school admission while subject exams and the HESI Exit Exam are used throughout the program. HESI scores are reported as percentages with most programs requiring 75-80% minimum.

Key Differences

ATI uses proficiency levels while HESI uses percentage scores. ATI emphasizes clinical application while HESI includes more knowledge recall questions. ATI provides a detailed Focused Review after each exam while HESI provides category scores.

Which is Harder?

Most nursing students report ATI proctored exams feel more challenging due to the clinical application focus. However, difficulty is subjective and depends on your learning style and the specific subject being tested.

How to Prepare for ATI

Use ATI Active Learning Templates to organize content. Complete the full Focused Review after each practice assessment. Target your weakest content areas before your proctored exam.

How to Prepare for HESI

Use Elsevier Evolve practice resources. Focus on case studies and alternate-format questions. Review category scores and prioritize categories where your percentage is below 75%.