Getting into a registered nurse program requires completing prerequisite courses, passing an entrance exam, and submitting a competitive application. The process typically takes one to two years of preparation before you even start the nursing program itself. Here’s what that path looks like from start to finish.
Choose Between an ADN and a BSN
Your first decision is which type of RN program to pursue. An Associate Degree in Nursing (ADN) takes about two years and is offered at community colleges, with tuition typically running between $6,000 and $20,000. A Bachelor of Science in Nursing (BSN) is a four-year degree at a university, costing anywhere from $40,000 to over $200,000 depending on the school. Both degrees qualify you to sit for the NCLEX licensing exam and work as a registered nurse.
The salary difference is real. BSN holders earn an average of about $92,000 per year compared to $75,000 for ADN holders, according to PayScale data from 2023. Many hospitals also prefer or require a BSN for hiring, and you’ll need one if you ever want to move into management or advanced practice roles. That said, an ADN gets you working faster and at a fraction of the cost. Many nurses start with an ADN and complete an online RN-to-BSN bridge program while working.
Complete the Prerequisite Courses
Every nursing program requires a set of prerequisite courses before you can apply. The specifics vary by school, but the core science requirements are remarkably consistent:
- Anatomy and Physiology I and II (lecture and lab)
- Microbiology
- General or organic chemistry
- Biology
- Statistics
- Nutrition
- Developmental psychology (sometimes called Human Development Across the Lifespan)
You’ll also need English composition and several general education courses in areas like humanities, social sciences, and cultural studies. Most programs require a C or higher in every prerequisite, though competitive applicants earn mostly A’s and B’s. Many schools also impose a freshness requirement on science courses. Seven years is a common cutoff, meaning if you took anatomy a decade ago, you’ll likely need to retake it.
If you’re starting from scratch, plan on at least two to three semesters of full-time coursework to get through prerequisites. Community colleges are the most affordable option and are widely accepted by both ADN and BSN programs.
Earn Strong Grades in Science
Your GPA matters more than almost anything else on your application. Many nursing programs use a points-based ranking system to select students, and your grades in science courses carry the heaviest weight. At one community college program, for example, an A in Anatomy and Physiology earns 8 points while a C earns only 3. Statistics grades are weighted less heavily, with an A worth 6 points and a C worth 2. These point differences add up fast when programs are ranking hundreds of applicants.
Most programs require a minimum cumulative GPA of around 2.75, with a separate minimum for science courses (often 2.5 or higher). But minimums are just the floor. At competitive programs, admitted students often have GPAs above 3.5. If you’re struggling in a prerequisite, it’s sometimes worth withdrawing and retaking it rather than earning a low grade, though be aware that some programs note withdrawals or limit course repeats.
Take the Entrance Exam
Nearly all nursing programs require either the TEAS (Test of Essential Academic Skills) or the HESI A2 as part of your application. The TEAS is the more widely accepted of the two, so if you’re applying to multiple schools, it’s often the safer choice.
The TEAS covers reading, math, science, and English language usage. The HESI A2 tests math, reading, vocabulary, grammar, and anatomy and physiology, with some schools adding extra sections. Passing scores vary by school, but higher scores earn you significantly more points in the selection process. At one program’s scoring rubric, a TEAS score of 90 to 100 earns 10 points, while a score in the low 70s earns just 4. That six-point gap could easily be the difference between admission and the waitlist.
Study guides and practice exams are widely available for both tests. Most students spend four to eight weeks preparing, focusing especially on the science section, which tends to be the most challenging.
Build Healthcare Experience
Strong grades and test scores get you most of the way there, but real-world healthcare experience rounds out your application and helps you stand out. The most direct route is earning a Certified Nursing Assistant (CNA) certification, which takes only a few weeks and lets you work in hospitals or long-term care facilities while you complete prerequisites. Working as an EMT or medical assistant serves a similar purpose.
Volunteering at a hospital, hospice, or community health clinic counts too. Leadership roles in student organizations, community service, and experience working with diverse populations all demonstrate the kind of initiative and interpersonal skills nursing programs value. Certifications like Basic Life Support (BLS) are inexpensive, take only a few hours to complete, and signal that you’re already investing in clinical readiness.
Verify the Program’s Accreditation
Before you apply anywhere, confirm that the program is accredited by one of two bodies: the Commission on Collegiate Nursing Education (CCNE) or the Accreditation Commission for Education in Nursing (ACEN). Both are recognized by the U.S. Department of Education. CCNE accredits only BSN and graduate-level programs, while ACEN covers everything from LPN diplomas to doctoral degrees.
This isn’t a minor detail. In some states, graduates of non-accredited programs aren’t allowed to take the NCLEX licensing exam at all. An unaccredited program can also create problems if you later want to transfer credits or pursue an advanced degree. Every legitimate program will list its accreditation status prominently on its website.
Prepare for the Application Timeline
Nursing programs typically admit students once or twice a year, with fall being the most common start date. Application deadlines often fall several months before the semester begins, sometimes as early as the preceding fall or winter for a program starting the following summer or fall. The centralized application service NursingCAS, used by many BSN programs, opens its cycle in early August each year.
Give yourself plenty of lead time. Transcripts from every college you’ve attended need to be officially sent to the program, which can take weeks. Letters of recommendation require advance notice to your references. If the program uses NursingCAS, your references will submit through the system, but they still need time. Start gathering these materials at least two months before the deadline.
Many applicants underestimate how early the process begins. If you’re aiming to start a nursing program in fall 2026, you should be finishing prerequisites and taking your entrance exam by early 2026, with applications going out that winter or spring.
Complete Health and Background Requirements
Once you’re admitted, you’ll need to clear several requirements before starting clinical rotations. These typically include:
- Immunizations: measles, mumps, rubella, hepatitis B, varicella, tetanus-diphtheria-pertussis, tuberculosis screening, flu vaccine, and COVID-19 vaccination
- Background checks: criminal record checks, FBI fingerprinting, sex offender registry searches, and sometimes child abuse clearances
- Drug screening: a 10-panel drug test is standard
- CPR certification: BLS for Healthcare Providers, specifically
These requirements come from the clinical sites (hospitals, clinics) where you’ll train, not just the school itself. Background checks are typically repeated annually. A criminal record doesn’t automatically disqualify you, but certain offenses, particularly those involving violence, theft, or drugs, can prevent you from completing clinical placements and ultimately from obtaining a nursing license. If you have concerns, contact your state board of nursing before investing time and money in prerequisites.
What a Competitive Application Looks Like
Pulling it all together, the strongest applicants to RN programs typically have a cumulative GPA above 3.5 (and close to 4.0 in sciences), a TEAS or HESI score in the 80s or 90s, some form of direct patient care experience, and a clean background check. At points-based programs, every grade and every test score percentage point translates directly into your ranking against other applicants. An applicant with straight A’s in science courses, a TEAS score above 90, and a 4.0 technical GPA could score near the maximum on the selection rubric, while someone with B’s and C’s and a mid-70s TEAS score might fall 20 or more points behind.
If your first application isn’t successful, find out where you lost points. Retaking a science course to improve a grade or studying harder for a second attempt at the entrance exam can meaningfully change your ranking. Many admitted students applied more than once before getting in.