I'm in my final semester of nursing school, and I'm genuinely terrified of my upcoming HESI exams.
I take my Pharmacology HESI in about 13 days, followed by my cumulative RN Exit HESI in about a month. I've historically performed pretty poorly on HESIs, usually scoring somewhere between 600–700, including on my Med-Surg HESIs. This time, I really need to score at least a 900. The frustrating part is that I feel like I've tried just about everything. I've reviewed my lecture notes, used NCLEX Bootcamp, YourBestGrade, Simple Nursing, Nexus Nursing, and other resources. I've tried the whiteboard method, studying with friends, explaining concepts out loud, and doing practice questions. I've spent money on subscriptions, and I genuinely feel like I'm putting in the effort, but my scores never seem to reflect that.
My biggest problem with the HESI isn't necessarily prioritization. It's being tested on things I genuinely don't recognize. Everyone always says to use ABCs, Maslow's hierarchy, safety, and prioritization strategies. I understand those concepts, but how am I supposed to prioritize interventions for a disease I've never heard of or choose the correct medication when I don't even recognize its name? For example, if a question presents a disease I'm unfamiliar with, I might not know which complication is most life-threatening, which assessment finding is expected versus concerning, or why one intervention would take priority over another.
The same thing happens with pharmacology. If I don't recognize a medication, I don't know its mechanism of action, major adverse effects, contraindications, or what I should monitor. I can try eliminating answers, but sometimes it feels like I'm just guessing.
I understand that nursing school can't teach us every single disease and medication in existence. But that's exactly what makes these exams so overwhelming for me. I can study everything we've covered in class and still encounter questions where I have absolutely no idea what's going on.
I'm not looking for another generic recommendation to "just do practice questions" or "remember your ABCs." I've been doing those things, and I'm still struggling.
For those of you who consistently scored 900+ on your HESIs, especially the Pharmacology and RN Exit HESI: How did you approach questions involving unfamiliar diseases or medications? Were there specific ways you learned to recognize medication classes, complications, or disease patterns without memorizing everything? What did you do differently that actually improved your HESI scores? If you previously scored in the 600–700 range and eventually reached 900+, what changed?
I'm honestly scared of failing and getting kicked out after making it this far in nursing school. I don't expect to know everything, but I want to feel like I have a fighting chance when I encounter something unfamiliar.
Any genuine advice, especially from people who struggled with HESI themselves, would mean a lot.