HESI A2 Test Accommodations: ADA & Disability Guide for 2026

Understanding HESI A2 Test Accommodations

If you have a documented disability — whether it's a learning disability like dyslexia, attention-deficit/hyperactivity disorder (ADHD), a physical disability, a chronic health condition, or a psychological disorder — you have the legal right to reasonable accommodations on the HESI A2 exam under the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act.

Yet many students don't request accommodations because they don't know they qualify, feel embarrassed, or don't understand the process. This guide walks you through everything: who qualifies, what accommodations exist, how to request them, and how to study effectively with your specific needs in mind.

Who Qualifies for HESI A2 Accommodations?

You may qualify for accommodations if you have a documented disability that substantially limits one or more major life activities, including learning, reading, concentrating, thinking, or communicating. Common qualifying conditions include:

Learning Disabilities

Dyslexia — difficulty with reading fluency, decoding, and comprehension
Dyscalculia — difficulty with mathematical concepts and calculations
Dysgraphia — difficulty with writing and fine motor skills
Auditory processing disorder — difficulty processing verbal information
Visual processing disorder — difficulty interpreting visual information

Attention and Executive Function Disorders

ADHD (Inattentive, Hyperactive, or Combined type) — difficulty sustaining attention, staying organized, or managing impulses
Executive function disorder — difficulty with planning, organizing, and completing tasks

Physical and Sensory Disabilities

Visual impairments — low vision, blindness, or color blindness
Hearing impairments — deafness or hard of hearing
Mobility impairments — conditions affecting the use of hands, arms, or ability to sit for extended periods
Chronic pain conditions — fibromyalgia, arthritis, or other conditions requiring frequent breaks

Psychological and Medical Conditions

Anxiety disorders — generalized anxiety, panic disorder, or test anxiety (when clinically documented)
Depression — major depressive disorder affecting concentration and processing speed
PTSD — post-traumatic stress disorder
Traumatic brain injury (TBI)
Epilepsy and seizure disorders
Autoimmune conditions — lupus, MS, or Crohn's disease requiring medication breaks

Available HESI A2 Accommodations

The specific accommodations available depend on your disability and how it affects your test-taking ability. Common accommodations include:

Time-Related Accommodations

Extended time (1.5x or 2x): The most commonly granted accommodation. If a section normally allows 25 minutes, you'd receive 37.5 or 50 minutes.
Extra breaks: Additional rest periods between sections or as needed during testing
Stop-the-clock breaks: Breaks that don't count against your testing time (for medical needs like medication, insulin checks, etc.)

Environment Accommodations

Separate/private testing room: Reduced distractions for ADHD or anxiety
Reduced-distraction environment: Smaller group setting with fewer test-takers
Preferential seating: Near the front, near the door, or in a specific location
Adjusted lighting: For photosensitivity or visual conditions

Assistive Technology and Tools

Screen reader or text-to-speech software: For visual impairments or reading disabilities
Screen magnification: Enlarged text and images on the computer screen
Alternative input devices: Trackball mouse, adaptive keyboard, or voice input
Calculator (basic): For dyscalculia (note: calculators are typically provided for the math section already)

Format and Presentation Accommodations

Large print: Enlarged test materials
High-contrast display: Modified color schemes for visual processing
Reader: A person who reads questions aloud to you
Scribe: A person who records your answers (for mobility impairments)

How to Request Accommodations: Step-by-Step Process

The process for requesting HESI A2 accommodations involves your nursing school's testing center, the Elsevier accommodations team, and your healthcare provider. Start this process early — ideally 6-8 weeks before your planned test date.

Step 1: Contact Your Nursing School's Disability Services Office (6-8 Weeks Before)

Your first stop is your school's disability services or accessibility office. They will:

Review your documentation
Determine which accommodations are appropriate
Submit the accommodation request to Elsevier (the company that administers the HESI A2)
Coordinate with the testing center

Important: Accommodations are not requested directly through Elsevier by students. You must go through your school's disability services office.

Step 2: Gather Required Documentation

You'll need comprehensive documentation of your disability. Requirements typically include:

Diagnostic evaluation: A formal assessment from a licensed professional (psychologist, psychiatrist, physician, or specialist) conducted within the last 3-5 years
DSM-5 diagnosis: Your specific diagnosis using current diagnostic criteria
Functional limitations: How your disability specifically affects your ability to take standardized tests
Treatment history: Current medications, therapy, or other treatments
Previous accommodations: Documentation of accommodations received in prior educational settings, including high school IEP/504 plans or college accommodations
Professional recommendation: Your provider's specific recommendation for which accommodations you need and why

Step 3: Submit Your Request

Work with your disability services office to submit a formal accommodation request packet. This typically includes:

Completed accommodation request form (provided by your school)
Your documentation package
A personal statement describing how your disability affects test-taking (optional but recommended)

Step 4: Wait for Approval (Allow 2-4 Weeks)

Review can take 2-4 weeks. During this time:

Continue your HESI A2 preparation as planned
Follow up with disability services if you haven't heard back within 2 weeks
If denied, ask about the appeals process — you have the right to appeal

Step 5: Confirm Testing Arrangements

Once approved, confirm:

Your exact test date and time
The testing location (it may differ from the standard testing room)
Exactly which accommodations will be in place
What you need to bring (documentation of accommodations approval, photo ID)

Study Strategies for Specific Disabilities

Beyond requesting accommodations, tailoring your study approach to your specific needs can dramatically improve your preparation. Here are evidence-based strategies for common conditions:

Studying with Dyslexia

Use text-to-speech: Have study materials read aloud while you follow along visually — dual-channel input improves comprehension
Color-code everything: Use different highlighter colors for different categories of information
Study with audio: Record yourself reading key concepts and listen during commutes
Use structured formats: Flashcard-based studying breaks content into manageable chunks
Practice with timed sections: Even if you'll have extended time, practice under time pressure to build processing speed
Focus on medical prefixes/suffixes: Learning root words gives you decoding tools for unfamiliar vocabulary

Studying with ADHD

Pomodoro Technique: Study in 25-minute focused bursts with 5-minute breaks. After 4 cycles, take a 30-minute break
Body doubling: Study alongside another person (in person or virtually) — their presence helps maintain focus. Consider a study group
Movement breaks: Walk, stretch, or do jumping jacks between study sessions — physical movement resets attention
Minimize distractions: Use website blockers, noise-canceling headphones, or study in a library
Active study methods only: Passive reading won't stick. Use practice questions, teach-back methods, and mnemonics
Medication timing: If you take ADHD medication, schedule your study sessions during peak medication effectiveness. Plan your test time similarly

Studying with Dyscalculia

Visual math: Draw diagrams, use number lines, and create visual representations of problems
Step-by-step templates: Create written step-by-step procedures for every type of math problem you'll encounter
Dimensional analysis: For unit conversions, this systematic method reduces the need for intuitive number sense
Real-world practice: Apply dosage calculations to real scenarios (cooking measurements, tip calculations) to build number familiarity
Calculator proficiency: If you're approved for a calculator accommodation, practice with the specific type you'll use

Studying with Anxiety Disorders

Gradual exposure: Simulate test conditions progressively — start untimed, then loosely timed, then strictly timed
Breathing techniques: Master anxiety management strategies and practice them until they're automatic
Cognitive reframing: Replace "I'm going to fail" with "I'm prepared and this is one test on my journey"
Over-prepare strategically: Knowing the material thoroughly reduces anxiety. Focus on your weakest areas first so nothing feels like a surprise
Visualization: Regularly visualize yourself calmly working through the exam, feeling confident, and succeeding

Studying with Visual Impairments

Screen magnification during study: Match the magnification level you'll use during the actual exam
High-contrast materials: Increase contrast on your screen and in printed materials
Audio learning: Supplement visual study with audio resources — podcasts, recorded lectures, and text-to-speech
Tactile aids for anatomy: Use 3D models or tactile diagrams when studying anatomy and physiology

What to Do If Your Accommodation Request Is Denied

Denials happen, but they're not the end of the road. Common reasons for denial and how to respond:

Reason: "Insufficient Documentation"

Solution: Ask specifically what's missing. Common gaps include outdated evaluations (more than 3-5 years old), lack of DSM-5 diagnosis, or missing functional impact statements. Get updated documentation from your provider.

Reason: "Disability Not Substantially Limiting"

Solution: Request a more detailed evaluation from your provider that specifically describes how your condition affects standardized test-taking, including processing speed, reading rate, or sustained attention metrics.

Reason: "Accommodation Not Reasonable"

Solution: Discuss alternative accommodations with your disability services office. There may be a different accommodation that addresses your needs and is considered reasonable for the testing format.

The Appeals Process

Request the denial in writing with specific reasons
Gather additional documentation addressing the denial reasons
Submit a formal appeal through your school's disability services office
If the school-level appeal fails, contact the Office for Civil Rights (OCR) at the U.S. Department of Education

Test Day with Accommodations: What to Expect

Test day looks a little different when you have accommodations. Here's how to prepare:

Before the Exam

Bring your accommodation approval letter (printed copy)
Arrive 15-20 minutes early to get set up
Confirm that all approved accommodations are in place before starting
Bring any approved personal items (medication, snacks for breaks, fidget tools)
If you have a separate testing room, locate it beforehand

During the Exam

Extended time users: Don't rush just because other students finish before you. Use your full allotted time. Pace yourself using a watch or the on-screen timer
Break users: Take breaks when you need them — that's why they were approved. Don't push through fatigue trying to be "tough"
Assistive technology users: If using screen readers or magnification, practice with the specific software beforehand if possible

Pacing Strategy for Extended Time (1.5x)

With 1.5x time on a 25-minute section, you have approximately 37-38 minutes. Budget your time:

First pass: Answer all questions you know immediately (15-18 minutes)
Second pass: Work through flagged/difficult questions (12-15 minutes)
Final review: Check your answers for any errors (5-7 minutes)

For more pacing strategies, read our complete test day guide.

Accommodations and Nursing School: Beyond the HESI A2

Getting accommodations for the HESI A2 also prepares you for accommodations throughout nursing school. Many of the same accommodations (extended time, separate testing, assistive technology) can be used for nursing exams, skills labs, and clinical rotations.

Important note: Having accommodations on the HESI A2 does not negatively affect your nursing school application. Schools cannot discriminate based on disability, and most admissions committees never see your accommodation status — they only see your scores.

Frequently Asked Questions

Will accommodations lower my score or flag my results?

No. Your HESI A2 score report does not indicate that you received accommodations. Your scores are reported the same way as every other test-taker's.

Can I request accommodations if I've never been formally diagnosed?

You need a formal diagnosis from a licensed professional. If you suspect you have a disability but haven't been evaluated, start with your primary care provider, who can refer you to a specialist. Many college disability services offices can also help connect you with evaluation resources.

How much does it cost to get evaluated for a disability?

Neuropsychological evaluations can range from $500-$3,000 without insurance. However, many options exist to reduce costs:

Your health insurance may cover evaluations (check with your provider)
University psychology training clinics often offer reduced-cost evaluations
Community mental health centers may offer sliding-scale fees
Vocational rehabilitation agencies may cover evaluation costs

I had accommodations in high school. Do those still count?

Your high school IEP or 504 plan serves as supporting evidence, but you may need updated documentation for college-level testing. Contact your school's disability services office with your existing records — they'll tell you if additional documentation is needed.

What if I'm taking the HESI A2 at a Prometric or PSI testing center?

The accommodation process still goes through your nursing school's disability services office, even if you test at an external center. They coordinate directly with the testing center to ensure accommodations are in place.

Resources and Next Steps

Ready to begin the accommodation process? Here's your action plan:

This week: Contact your nursing school's disability services office to schedule an intake meeting
This month: Gather all relevant documentation (evaluations, IEP/504 records, medical records)
Start studying: Begin your HESI A2 preparation using the disability-specific strategies above
6-8 weeks before your test: Submit your accommodation request
1 week before your test: Confirm all accommodations are in place and review our last-minute study guide

Having a disability doesn't define your potential as a nursing student — it simply means you learn and demonstrate knowledge differently. With the right accommodations and preparation, you can achieve the HESI A2 score you need to begin your nursing career.