HESI Exam Reading Comprehension Guide: What to Expect and How to Prepare

The Reading Comprehension section of the HESI exam is designed to assess how well a student can understand, interpret, and analyze written text. This section reflects real-world reading skills that nursing and healthcare professionals need to effectively read and understand patient documentation, medical literature, and communication materials. Understanding written content is essential not only for passing the exam but for long-term success in the medical field.

The section consists of 47 multiple-choice questions and is intended to be completed in less than an hour. Each question is tied to a specific reading passage. The difficulty of these passages can vary significantly and may reflect different types of texts, including:

• Literary passages from fiction or non-fiction books 
• Informational texts such as essays and academic articles 
• News reports and journalistic writing 
• Speeches or excerpts from spoken-word content 

Regardless of the form, the main purpose of each passage is to provide content that students must analyze through the lens of comprehension and interpretation.

What the Test Measures

This portion of the exam evaluates several core reading skills. These include:

• Identifying the main idea or topic of a passage 
• Understanding the purpose and tone of the author 
• Distinguishing between facts and opinions 
• Drawing inferences and conclusions based on the text 
• Interpreting the meaning of words and phrases using context 
• Recognizing the structure and style of the writing 
• Analyzing rhetorical strategies or literary devices used by the author 

By assessing these skills, the exam aims to determine a student’s ability to read critically and understand deeper meanings within a variety of texts. Success on this section depends not only on reading speed but also on the ability to break down and process information methodically.

Types of Questions You May Encounter

The questions on the HESI Reading Comprehension section are all multiple-choice, with each tied to a short passage or excerpt. There are typically several questions for each passage, and each one may focus on a different aspect of comprehension.

Some of the common question types include:

• Identifying the main idea or central argument 
• Recognizing supporting details or evidence 
• Interpreting vocabulary based on context 
• Identifying the author’s tone or emotional stance 
• Determining the structure of the passage 
• Understanding the author’s purpose or perspective 
• Making logical inferences from the information given 
• Identifying stylistic or rhetorical devices 

Many of these questions require more than simple recall. Instead, they demand a close reading of the passage and a thoughtful interpretation of the text’s deeper meaning. This means you need to be able to read between the lines and connect different parts of the passage to fully understand what is being communicated.

Reading Passage Formats and What to Expect

The passages on this test vary in structure and topic. Some may be narrative in style, telling a story or describing an event. Others may be expository, explaining an idea or process in a logical format. You might also encounter persuasive texts that aim to convince the reader of a particular viewpoint. These stylistic differences require test takers to quickly identify the text type and adapt their reading strategy accordingly.

Some passages will be straightforward to follow. Others will include more sophisticated vocabulary, complex sentence structures, or abstract concepts. Being prepared to face a variety of formats is essential. Practice with different reading materials can help strengthen your adaptability and ensure that you are ready for any type of passage presented on the exam.

Key Concepts to Review Before the Exam

There are several important reading and literary concepts that every test-taker should review before taking the HESI exam. These concepts help in understanding both the content and the form of the passages.

Some of the foundational concepts to understand include:

• Main idea: The central point or message of a passage 
• Supporting details: Facts, examples, and explanations that reinforce the main idea 
• Inference: A conclusion drawn from evidence and reasoning, rather than from explicit statements 
• Tone: The author’s attitude toward the subject or audience 
• Purpose: The reason the author wrote the passage (e.g., to inform, persuade, entertain) 
• Point of view: The perspective from which the passage is written (e.g., first person, third person) 
• Structure: The way the text is organized (e.g., chronological, cause and effect, compare and contrast) 
• Style: The author’s use of language, including sentence structure, vocabulary, and literary devices 
• Context clues: Words or phrases in the surrounding text that help define an unfamiliar word 

These concepts are frequently referenced in the questions, and having a strong grasp of them will improve your ability to analyze and respond accurately.

Practice and Preparation Techniques

One of the best ways to prepare for the HESI Reading Comprehension section is through consistent and targeted practice. Begin by taking a diagnostic test to identify your strengths and weaknesses. Once you understand where you need the most help, you can focus your studying more effectively.

Practicing with realistic reading passages and question sets will help you become familiar with the style and format of the exam. Try to simulate real test conditions by setting a timer and working without interruptions. This will not only help you get used to the pressure of timed testing but will also improve your focus and endurance.

Make sure to review the explanations for both correct and incorrect answers after each practice session. Understanding why a particular answer is correct or incorrect is key to learning how to approach similar questions in the future.

Vocabulary Development Through Context

The HESI exam often includes vocabulary-in-context questions, where you must determine the meaning of a word based on how it is used in the passage. You do not need to memorize an extensive list of vocabulary words. Instead, focus on developing your ability to interpret unfamiliar words using the surrounding context.

Some helpful tips for mastering vocabulary-in-context questions include:

• Look at the sentence before and after the unfamiliar word 
• Identify any synonyms or definitions given nearby. 
• Look for tone or connotation clues that suggest a positive or negative meaning.g 
• Eliminate answer choices that don’t fit the context. 

Over time, reading a variety of complex texts—such as academic articles, news reports, and literature—will naturally improve your vocabulary and help you become more comfortable interpreting new words.

The Importance of Critical Thinking

Beyond basic comprehension, the HESI exam evaluates your critical thinking skills. This means you will be expected to interpret what the author implies, assess the strength of arguments, and identify biases or assumptions in the text.

To strengthen critical thinking skills, practice identifying:

• Hidden assumptions behind a statement 
• The difference between fact and opinion 
• Weaknesses or gaps in reasoning 
• Evidence used to support an argument. 
• Contradictions or inconsistencies in the passage 

Becoming a critical reader requires practice, patience, and the willingness to question what you read. The more comfortable you become with this process, the better prepared you will be for the most challenging questions on the HESI exam.

Using Active Reading Strategies

To increase your accuracy and efficiency, practice active reading while working through practice passages. This involves:

• Annotating or taking brief notes as you read 
• Identifying key ideas in each paragraph 
• Marking unfamiliar vocabulary for context analysis 
• Noting the overall structure and flow of the passage 
• Summarizing the main idea in your own words 

Even though the actual test will be on a computer and you cannot mark up the passage directly, developing the habit of active engagement will help your brain retain and analyze the material more effectively. By mentally or physically summarizing as you read, you will improve your understanding and reduce the need to reread large sections.

Reviewing Key Skills for HESI Reading Comprehension

Identifying the Main Idea and Supporting Details

One of the foundational reading skills assessed on the HESI exam is the ability to identify the main idea of a passage. The main idea is the central point or the most important concept that the author wants the reader to understand. It is usually supported by additional sentences that provide examples, explanations, or facts to reinforce the point being made.

To determine the main idea, ask yourself:

• What is the author trying to say overall? 
• What do all the details in the passage point toward? 
• Is there a sentence that seems to summarize the author’s argument? 

Supporting details, meanwhile, help validate and expand upon the main idea. These may come in the form of statistics, examples, personal anecdotes, or historical facts. Recognizing which parts of the passage are central to the main idea and which ones serve as additional context is a skill that improves with practice and focused reading.

Determining the Author’s Purpose

The author’s purpose refers to the reason behind writing the passage. Typically, a passage is written to inform, persuade, entertain, or express a viewpoint. Identifying this purpose helps in understanding the overall direction of the passage and what the reader is expected to take away from it.

To recognize the author’s purpose, consider the tone and structure of the text:

• Informational passages present facts, definitions, or explanations in a neutral tone. 
• Persuasive texts often include emotionally charged language and seek to convince the reader of a particular opinion. 
• Entertaining or expressive texts might use humor, storytelling, or rich descriptive language. 

Clues like the use of persuasive language, the presence of emotional appeals, or objective data help identify the purpose. Recognizing this will not only help in answering direct questions about purpose but will also improve your ability to draw accurate inferences.

Understanding Tone and Point of View

The tone of a passage refers to the author’s attitude toward the subject or the audience. A tone can be serious, formal, informal, sarcastic, optimistic, or neutral. Determining tone often involves paying close attention to the choice of words, sentence structure, and emotional content of the passage.

Tone questions often ask how the author feels about the topic or how the tone affects the message being conveyed. Look for emotional language, repetition, punctuation, and qualifiers that may suggest the author’s perspective or feelings.

Point of view refers to the perspective from which the passage is written. On the HESI exam, you may be asked to identify whether a passage is written in first person (using “I” or “we”), second person (using “you”), or third person (using “he,” “she,” or “they”). Understanding the point of view can help you analyze how personal or objective the passage is, which may influence its tone and style.

Making Inferences and Drawing Conclusions

Inference questions are among the most challenging on the reading comprehension portion of the HESI exam. These questions ask you to read between the lines and conclude what is not explicitly stated in the text. In other words, you must use the information provided to make a logical assumption.

To answer inference questions accurately:

• Pay close attention to specific details and how they relate to one another. 
• Consider what the author implies, even if it is not directly stated. 
• Think about the broader message or consequence of the information given. 

Avoid making assumptions based on outside knowledge or personal opinions. All inferences must be grounded in the passage itself. Developing this skill requires close reading and an understanding of how ideas are subtly presented in text.

Differentiating Fact from Opinion

The ability to distinguish between factual statements and opinions is critical for evaluating the credibility and reliability of a passage. A fact can be proven true or false through evidence, while an opinion reflects beliefs, interpretations, or preferences that cannot be proven.

You may see questions that ask:

• Which of the following statements is a fact? 
• Which of these is an opinion expressed by the author? 

To answer these questions, look for clues:

• Facts are often supported by data, examples, or sources. 
• Opinions often include qualifiers such as “should,” “believe,” “best,” or “worst.” 
• Emotional or subjective language usually indicates an opinion. 

Being able to tell the difference between fact and opinion helps not only in answering specific questions but also in evaluating the argument and tone of the passage.

Analyzing Text Structure

Text structure refers to how the information within a passage is organized. Understanding the structure of a text helps you predict what information will come next and how it relates to the overall message. Common text structures include:

• Chronological order: Events are presented in the order they occurred. 
• Cause and effect: The passage explains the reasons something happened and the resulting consequences. 
• Compare and contrast: The author highlights similarities and differences between two or more subjects. 
• Problem and solution: A problem is introduced, followed by one or more proposed solutions. 
• Description: The passage provides detailed information about a topic. 

Being able to recognize these structures can help you navigate the passage more efficiently and find relevant information more quickly during the exam.

Context Clues and Vocabulary

You may be asked to define a word or phrase as it is used in the context of the passage. These questions do not test memorized vocabulary but rather your ability to use surrounding information to determine meaning. Context clues are especially important for unfamiliar or complex terms.

Types of context clues include:

• Definition: The word is directly defined in the sentence or nearby. 
• Synonym: A similar word is used nearby to explain the meaning. 
• Antonym: A contrasting word is used to highlight the difference. 
• Example: Specific examples help clarify the meaning of the word. 
• General context: The overall meaning of the passage helps you infer the word’s meaning. 

Practice reading complex passages and pause when you encounter an unfamiliar word. Try to determine its meaning based on context before checking a dictionary. This habit strengthens your understanding of how words function in real-world texts.

Recognizing Rhetorical and Literary Devices

Some questions may ask about the rhetorical or literary strategies used in a passage. These devices are tools authors use to communicate their message more effectively or to enhance the emotional or persuasive impact of the text.

Common devices to review include:

• Metaphor and simile: Comparisons that illustrate or emphasize ideas 
• Hyperbole: Exaggeration used to make a point 
• Onomatopoeia: Words that imitate sounds 
• Alliteration: Repetition of initial consonant sounds 
• Rhetorical question: A question asked for effect, not requiring an answer 
• Parallel structure: Repetition of grammatical forms for emphasis or rhythm 

Being familiar with these terms helps you answer questions related to how the passage is constructed and how the author engages the reader.

Strategies for Approaching Questions

Each question should be approached methodically. Start by reading the question carefully, noting any keywords or instructions such as “except,” “best,” “mainly,” or “most nearly.” These qualifiers significantly impact the correct answer.

Then, return to the passage and locate the relevant section that addresses the question. Avoid relying on memory or skimming. Even if you think you remember the answer, verifying it in the text can prevent avoidable mistakes.

Eliminate incorrect answer choices, and focus on the two or three most plausible options. Re-read those in the context of the question and the passage. When in doubt, go with the answer most directly supported by the passage.

Effective Test-Taking Strategies for the HESI Reading Comprehension Section

Practicing Ahead of Time

Preparation is a key element of success on the HESI Reading Comprehension section. Practicing with sample passages and question sets allows you to familiarize yourself with the structure, pacing, and types of questions you’ll encounter on test day. It also allows you to evaluate your current skill level and identify specific areas where you may need to improve.

Begin your preparation by taking a diagnostic test under realistic conditions. Use a timer and simulate the environment of the actual exam. Analyze the results to determine which questions you missed and why. Were you confused by the wording of the question? Did you misinterpret the passage? Were you unfamiliar with a key concept like inference or tone?

Once you’ve identified your weak points, devote time to studying and practicing those skills. Read a variety of materials—including news articles, essays, and short stories—and challenge yourself to answer comprehension questions you create or find in practice materials. Pay attention to the structure of each passage and how information is presented. Over time, you’ll develop the intuition and techniques needed to quickly process and evaluate text on the actual exam.

Creating a Study Plan That Works

Preparing effectively for the HESI requires a structured and realistic study plan. Rather than cramming all your studying into a single weekend or staying up late the night before the test, break your study time into manageable, consistent sessions over a longer period. This approach enhances long-term retention and reduces anxiety on test day.

When building your study plan:

• Set a specific goal for each study session. For example, you might focus on understanding the author’s purpose one day, and practice identifying supporting details the next. 
• Use a calendar to schedule your study blocks in advance. Make sure to allow time for review and rest. 
• Include both practice questions and reading assignments. The more you read challenging material, the more comfortable you’ll become with unfamiliar vocabulary, complex sentence structures, and sophisticated arguments. 
• Track your progress over time. Keep a notebook or spreadsheet with scores from practice tests, notes on recurring mistakes, and concepts that need more attention. 

Stick to your study plan as consistently as possible. Even if you can only dedicate 30 minutes a day, daily review and practice are more effective than long, infrequent sessions. Repetition builds mastery and confidence.

Simulating Real Test Conditions

One of the best ways to prepare for test day is to simulate the actual exam environment. This helps you develop both the mental and physical stamina needed to maintain focus for the duration of the exam. It also allows you to identify how you react under time pressure and develop strategies for managing it.

To simulate test conditions:

• Use a timer to limit yourself to the recommended time for the reading comprehension section, which is approximately one hour. 
• Avoid distractions. Find a quiet space where you won’t be interrupted. 
• Do not use notes, internet searches, or outside help during your practice test. 
• Refrain from taking breaks during the session. This helps train your ability to concentrate continuously for the length of the test. 

After each practice session, take time to review not only your answers but also how you managed your time. Did you run out of time before answering all the questions? Did you spend too much time on one difficult question? Were you rushing through at the end? Adjust your test-taking strategy accordingly.

Managing Time During the Exam

Time management is one of the most important factors in achieving a high score on the reading comprehension section. Although the test is not rigidly timed down to the second, you should aim to complete the section within the recommended time frame to stay on track for the entire exam.

A useful strategy is to divide your time based on the number of questions. With 47 questions and about 60 minutes to complete them, you have slightly over a minute per question. Some questions will take less time, allowing extra seconds for more challenging ones. Pay attention to your pace as you go.

To stay on track:

• Don’t spend too much time on any single question. If you find yourself stuck, make your best guess and mark it to return later if time permits. 
• Prioritize questions you feel confident about. Answer those quickly and accurately before devoting time to harder ones. 
• Keep an eye on the clock but avoid checking it too frequently, which can cause anxiety and reduce focus. 
• If you have extra time at the end, use it to review your answers, especially those you marked for review. 

Time pressure can affect accuracy, so practice answering questions efficiently while maintaining comprehension. Strive for a balance between speed and attention to detail.

Reading Questions Carefully

The way a question is worded on the HESI exam can be tricky. It’s important to read each question and all answer options carefully before making your selection. Words such as “most nearly,” “except,” “not,” and “best” can significantly change what the question is asking. Misreading these keywords can lead to incorrect answers, even when you understand the content of the passage.

Tips for careful question reading:

• Underline or mentally highlight key terms in the question that define what you’re being asked to do. 
• Read all answer choices before selecting one. Sometimes the first option might seem right, but a better answer is listed later. 
• Be cautious of answers with absolute terms like “always” or “never.” These are often incorrect because they are too limiting for real-world reading comprehension. 
• Avoid overthinking. Choose the answer that is most directly supported by the text, not the one that introduces outside knowledge or assumptions. 

Questions that use qualifiers like “most likely,” “primarily,” or “mainly” are looking for the strongest or most central idea, not every possible answer that seems plausible. Focus on choosing the option that best matches the question’s intent based on the passage content.

Approaching Answer Choices Strategically

In multiple-choice questions, understanding how to approach the answer choices can greatly improve your accuracy. Some choices may be completely off-topic, others may be partially correct, and one will be the best supported by the text.

To evaluate answer choices effectively:

• Eliminate incorrect options. Cross out choices that are unrelated to the topic or contradict the passage. 
• Compare the remaining choices. Ask yourself which one best answers the question according to the author’s words or intent. 
• Re-read the part of the passage related to the question, especially if you’re unsure between two similar-sounding answers. 
• Be cautious of distractor answers. These may use keywords from the passage but misrepresent their meaning. 
• Rely on the passage, not your opinion or outside knowledge. Even if an answer seems logically correct in general, it must be supported by what is written. 

Developing this strategic mindset helps prevent careless mistakes and allows you to approach each question methodically, rather than relying on guesswork.

When to Move On From a Question

Sometimes, despite your best efforts, a question just doesn’t click. In these cases, it’s important to know when to move on. Spending too much time trying to decode one challenging question can prevent you from answering easier questions later in the test.

If you’re unsure about a question:

• Make your best guess based on the options and move on. 
• Mark the question if the system allows you to return to it later. 
• Avoid changing your answer unless you find a clear reason to do so in your review. Your first instinct is often correct. 

Practicing this strategy during study sessions helps reduce stress and ensures that you maximize the number of questions you attempt during the test.

Final Preparation Tips and Exam-Day Confidence for HESI Reading Comprehension

Knowing What Tests to Take

Before beginning your HESI exam journey, it’s important to know which specific sections you are required to complete. While most nursing and allied health programs require the full set of HESI subjects—including Reading Comprehension, Vocabulary, Grammar, Math, and Sciences—not every school demands all of them.

Each program has its criteria, so start by reaching out to the admissions office or academic advisor at the institution you’re applying to. They can confirm exactly which test sections are necessary. This helps you avoid unnecessary preparation and ensures your study efforts are directed where they are truly needed.

Once you have the list of required sections, create a testing schedule that allows for adequate preparation. Consider taking easier sections first and saving more difficult ones for later, giving yourself extra time to study the material you find most challenging. Scheduling your test components strategically allows you to build confidence and momentum as you progress through the exam process.

Scheduling and Testing in a Logical Order

The flexibility of the HESI exam allows students to take different sections on separate days. This means you are not obligated to sit for all portions of the test in one session. For many students, this is a significant advantage, as it allows them to:

• Focus your mental energy on one subject area at a time 
• Study specifically for each section without feeling overwhelmed. 
• Spread out your testing dates to avoid burnout or information overload.d 

For example, if you are strong in reading and writing, you might take the Reading Comprehension and Grammar sections first. Then, give yourself additional time to review before taking more demanding subjects like Biology or Math. This strategy not only reduces stress but also increases your chance of success in each section.

Remember that passing scores and required sections vary by program, so your strategy should be tailored to meet those expectations. Always confirm how your school uses HESI scores and whether there is a minimum requirement for each subject.

Avoiding Last-Minute Cramming

Cramming is one of the least effective study methods for reading comprehension. While you might be able to memorize facts or formulas in a short period for other subjects, reading comprehension is a skill that builds over time. It involves your ability to process, analyze, and interpret written material, and that ability cannot be rushed.

Trying to absorb too much information at the last minute can increase anxiety, reduce focus, and make it harder to recall what you have learned. Instead of last-minute cramming, plan your review well in advance. Set aside regular study sessions for reading practice and comprehension drills. Build a consistent routine where you read a variety of passages and answer different types of questions.

In the final days leading up to the exam, shift your focus from new content to reviewing concepts you’ve already studied. This strengthens your confidence and helps solidify the strategies you’ll use on test day. Rest and a clear mind will serve you better than sleepless nights and frantic last-minute reviews.

Building Confidence Before the Exam

Confidence is a key ingredient for performing well on any exam. If you walk into the test room already convinced you’ll fail, you’re setting yourself up for unnecessary stress and self-doubt. Instead, build your confidence by reflecting on the preparation you’ve done and the progress you’ve made.

There are several ways to increase your self-assurance before test day:

• Take several full-length practice tests under timed conditions. The more you simulate the real test, the more prepared you will feel. 
• Review the explanations for both correct and incorrect answers. Understanding why an answer is right gives you a deeper level of comprehension and teaches you how to spot similar patterns in future questions. 
• Reflect on improvements. If your scores have increased over time or if you’re making fewer errors on specific question types, recognize that growth. 
• Use positive reinforcement. Tell yourself that you’ve studied hard, you’ve prepared well, and you’re capable of handling the exam. 

Confidence doesn’t mean being perfect. It means being ready and resilient—even if you face a tough passage or a confusing question.

Trusting Your First Instincts

It’s common for students to second-guess themselves on multiple-choice exams. After selecting an answer, you may begin to doubt your choice and feel tempted to change it. However, research and experience both show that first instincts are often correct, especially when you have read the passage carefully and made an informed choice.

Unless you find clear evidence in the passage that contradicts your original selection, resist the urge to change your answer. Doubt and nervousness can lead to overthinking, which results in lower accuracy. If you are genuinely unsure, it’s fine to mark the question and return to it later if time allows. But do not go back and start changing answers at random without a strong reason.

The more you practice trusting your first response in a calm and focused manner, the more confident and accurate you’ll become on the actual test.

Recognizing and Avoiding Common Pitfalls

There are several mistakes that even well-prepared students can make on the HESI Reading Comprehension section. Being aware of these potential pitfalls can help you avoid them and improve your overall performance.

• Reading too quickly: Skimming too fast may cause you to miss key ideas or misunderstand the passage’s structure. Take your time and read with purpose. 
• Misreading the question: Be alert to key words such as “not,” “except,” or “most nearly.” These small words can completely change the meaning of the question. 
• Over-relying on memory: Always return to the passage to confirm your answer. Even if you feel confident you remember the content, re-reading can help you catch important nuances. 
• Getting stuck on one question: Don’t let a single difficult question take up too much of your time. Move on and come back to it if you can. 
• Panicking under pressure: Stress can cloud your thinking. Stay calm, breathe, and remind yourself of your preparation and capability. 

Avoiding these habits requires mindfulness and deliberate practice, both of which can be built into your study sessions leading up to the exam.

Using Strategic Elimination

Not all multiple-choice answers are created equally. Often, two or three of the four choices can be ruled out with just a glance, even if you’re unsure about the correct one. Strategic elimination helps you narrow your options and increases your odds of selecting the right answer, even when you’re guessing.

Tips for using elimination effectively:

• Remove options that contradict the passage’s content. 
• Eliminate answers that contain extreme words like “always” or “never,” unless the passage supports such language. 
• Discard options that are only partially true or that don’t fully answer the question. 
• Compare the remaining options side-by-side to find the most accurate or relevant one. 

Even if you’re unsure between two possible answers, you now have a 50% chance of choosing correctly, better than a blind guess among four options. The more you practice this method, the more effective it becomes.

After the Exam: Reflecting and Preparing for Next Steps

Once you’ve completed the Reading Comprehension section of the HESI exam, take a moment to reflect on how the test went. What did you feel confident about? Which questions or passages caused difficulty? What strategies worked for you, and what would you improve next time?

If you are taking multiple sections of the HESI, use this insight to adjust your approach for the remaining parts of the exam. Consider whether you need more timed practice, better test-day pacing, or a review of specific content areas. This reflection process is especially helpful if you plan to retake the HESI or if you’re preparing for additional entrance exams in the future.

Even if you don’t yet know your score, giving yourself credit for preparing and completing the test is an important part of building confidence and resilience as a student. Success on the HESI Reading Comprehension exam is about more than just memorizing terms. It’s about demonstrating your ability to think critically, analyze information, and draw meaningful conclusions—skills that are essential in nursing and healthcare education.