The classes that matter most for a future nursing career in high school are biology, chemistry, anatomy and physiology (if your school offers it), and algebra or higher math. These subjects form the academic backbone of every nursing program you might apply to later, and research confirms that students who arrive at nursing school with a strong science foundation perform better once they get there. But science and math are just the starting point. A well-rounded schedule that includes psychology, English composition, and even a certified nursing assistant (CNA) course can set you apart when application time comes.
Biology Is the Single Most Important Class
If you take only one class with nursing in mind, make it biology. A retrospective study of practical nursing students found that completing a high school biology course roughly doubled the odds of succeeding in the program.1PubMed. Pre-admission factors associated with student success in a practical nursing program: A retrospective cohort study That finding makes intuitive sense: nursing programs hit the ground running with human anatomy, microbiology, and pathophysiology, and all of those courses lean heavily on concepts you first encounter in high school biology. Cell structure, basic genetics, organ systems, the immune response, how pathogens spread. If those ideas are already familiar, you can focus on the clinical detail rather than scrambling to learn the basics alongside it.
Most high schools require at least one year of biology, so this one usually takes care of itself. But if your school offers honors or AP Biology, taking the more rigorous version is worth considering. It will not guarantee you a spot in a competitive nursing program, but it signals academic seriousness and exposes you to the kind of study habits that college-level science demands.
Chemistry Builds the Foundation You Will Use Every Day
Chemistry is the second science course that pays clear dividends. Nursing students need to understand how medications interact with the body, how electrolyte imbalances affect organ function, and how intravenous solutions behave at a molecular level. Those topics are rooted in chemistry. Many bachelor of science in nursing (BSN) programs require at least one semester of college chemistry as a prerequisite, and students who already have a working knowledge of chemical bonds, solutions, pH, and basic organic chemistry from high school tend to move through those prerequisites faster.
Some students wonder whether physics is worth taking instead of or in addition to chemistry. Physics does appear in nursing education at the graduate and specialty level, particularly in topics like radiation safety, hemodynamics, and the mechanics of ventilation.2AIP Publishing (AIP Conference Proceedings). Biophysics in nursing education For most aspiring nurses, though, chemistry is far more directly useful than physics during the undergraduate years. If you have room for both, great. If you have to choose, chemistry wins.
Anatomy and Physiology If Your School Offers It
Not every high school has an anatomy and physiology (A&P) course, but if yours does, take it. The same study that found biology boosted nursing-program success showed even stronger associations for students who had completed one or more A&P courses before enrolling. Students who finished a single A&P course had more than twice the odds of success compared to those with none, and finishing two or more courses pushed those odds higher still.1PubMed. Pre-admission factors associated with student success in a practical nursing program: A retrospective cohort study Separate research on university health-science students confirmed that prior science performance and overall high school grades were significantly associated with how well students did in college-level human anatomy.3SciELO – Scientific Electronic Library Online. Factors associated with academic performance in undergraduate health sciences students enrolled in the human anatomy course
A&P is often the class that makes or breaks first-year nursing students. The volume of memorization is enormous, and the pace is fast. Having already learned the major organ systems, the skeletal and muscular structures, and the basics of how the body maintains homeostasis gives you a head start that compounds quickly. If your school offers it only as an elective or a dual-enrollment course through a local community college, it is still worth fitting into your schedule.
How Much Math You Actually Need
Nursing involves more math than most people expect. Dosage calculations, IV drip rates, unit conversions, and interpreting lab values all require comfort with arithmetic, ratios, and basic algebra. Most BSN programs require at least college algebra, and many require an introductory statistics course as well. In high school, that translates to completing Algebra I and Algebra II at minimum, with statistics or pre-calculus as a bonus if you can manage them.
That said, the relationship between math credentials and actual nursing competence is not as straightforward as it looks on paper. A study on whether school math qualifications predicted performance in nursing calculations found that formal credentials beyond a moderate threshold did not reliably predict who would perform well on the kinds of math nurses actually use.4PubMed Central. Do school qualifications predict competence in nursing calculations? In other words, having a high-level math grade is less important than genuinely understanding the math you do take. A student who deeply understands ratios, proportions, and unit conversions from Algebra II is better prepared for nursing math than a student who scraped through pre-calculus without retaining the fundamentals. Focus on mastery rather than chasing the most advanced math course available.
English and Communication Skills
Nursing is a communication-heavy profession. You will write patient assessments, document care plans, explain procedures to frightened families, and collaborate with physicians who may use very different vocabularies than you do. Strong reading comprehension and clear writing are not optional extras; they are tools you will use in nearly every shift.
Take four years of English if your school requires it, and consider AP English Language and Composition if you want practice with evidence-based writing and persuasive argument. Technical writing or a journalism elective can also sharpen the kind of concise, factual writing style that nursing documentation demands. The goal is not literary analysis for its own sake. It is the ability to read a dense passage (a medication insert, a policy document, a research abstract) and extract the information you need, then communicate it clearly to someone else.
Psychology and Sociology
Psychology is arguably the most directly useful elective for a future nurse outside the hard sciences. Understanding human behavior, motivation, stress responses, developmental stages, and mental health conditions is central to patient care. Most nursing programs include courses in developmental psychology and abnormal psychology, so a high school psychology class gives you a preview of that material.
Sociology may seem less obviously connected, but it shows up in nursing education more than you might expect. Research into how nursing students experience sociology within their curriculum found that the subject initially feels unfamiliar and even unsettling to students, yet they end up using sociological thinking to understand health disparities, professional dynamics, and the social determinants that shape their patients’ lives.5PubMed Central. Desperately seeking sociology: nursing student perceptions of sociology on nursing courses If your school offers sociology, anthropology, or a social issues course, it is worth considering. These classes build the kind of perspective that helps you care for patients from backgrounds very different from your own.
CTE Pathways and CNA Certification
Many high schools now offer career and technical education (CTE) tracks in health sciences. These programs often include courses like Medical Terminology, Health Science Foundations, and sometimes even a pathway to becoming a certified nursing assistant (CNA). If your school has a CTE health-science track, it can be an excellent complement to your academic course load.
Earning a CNA certification while still in high school lets you work in healthcare settings (nursing homes, hospitals, home health) before you even start a nursing program. Research has found that students who worked as nursing assistants reported higher confidence in basic nursing care skills when they entered their nursing program.6PubMed. Does nursing assistant certification increase nursing student’s confidence level of basic nursing care when entering a nursing program? However, the same study noted that nursing programs should not assume CNA-certified students are fully prepared, because the CNA scope of practice is narrow. Think of CNA work as a reality check and a confidence builder, not a shortcut through the clinical learning you will do in nursing school.
Beyond confidence, CNA work gives you something else that is hard to get any other way: direct exposure to what nursing actually feels like day to day. Dealing with bodily fluids, managing physically demanding tasks, interacting with patients who are confused or in pain. It is better to discover in high school whether bedside care is something you genuinely want to do, rather than finding out two years into a nursing program.
Computer Skills Matter More Than You Think
Modern nursing is deeply intertwined with technology. Electronic health records, medication barcode scanning, telehealth platforms, and clinical decision-support tools are all part of everyday nursing practice. A study of doctoral nursing students found that while basic computer skills and email use were rated above proficient, applied clinical informatics skills, particularly managing aggregated data, were rated below competent.7Healthcare Informatics Research. Informatics Competencies of Students in a Doctor of Nursing Practice Program: A Descriptive Study The gap between basic comfort with technology and the ability to use clinical software effectively is something nursing programs are still trying to close.
In high school, you can start bridging that gap by taking a computer applications course, a keyboarding class, or anything that exposes you to spreadsheets, databases, and basic data management. AP Computer Science Principles, if available, is a good option not because you need to learn programming, but because it builds computational thinking and data literacy. Even something as simple as becoming genuinely fast and accurate at typing will pay off during clinical rotations, when you need to document patient care quickly and correctly.
Foreign Language as a Practical Tool
A foreign language may seem unrelated to nursing, but in practice it can be one of the most useful things on your transcript. In any clinical setting, you will encounter patients who are more comfortable communicating in a language other than English. Spanish is the most commonly spoken non-English language in U.S. healthcare settings, and nurses who can hold even a basic conversation in Spanish have a real advantage in patient assessment and rapport-building.
Two or three years of a language in high school will not make you fluent, but it builds a foundation you can develop further in college or through clinical immersion experiences. Some nursing programs offer language-specific clinical components, and having prior coursework makes it much easier to participate. Beyond the practical benefits, many nursing programs value the cultural competence that comes with language study, and it can strengthen a holistic admissions application.
What Nursing Admissions Actually Look For
Knowing which classes to take is one thing; understanding how admissions committees evaluate your transcript is another. Nursing programs increasingly use holistic admissions processes that consider not just your grades and test scores but also your experiences, characteristics, and aptitudes. One nursing school that adopted holistic review for its pre-licensure program explicitly weighed clinical experiences, community involvement, and personal attributes alongside academic metrics.8PubMed Central. Using holistic admissions in pre-licensure programs to diversify the nursing workforce
This means that your overall GPA, the rigor of your course load, and your science grades all matter, but they are not the whole picture. Volunteering at a hospital or clinic, participating in health-related clubs, shadowing nurses, and working as a CNA all demonstrate the kind of commitment and self-awareness that admissions committees want to see. A student with a 3.5 GPA, a CNA certification, and 200 hours of hospital volunteering often looks stronger than a student with a 3.9 GPA and no healthcare exposure.
Programs aimed at sparking interest in nursing careers have found that reaching students during high school, especially during the fall of senior year when college applications are due, is particularly effective for guiding students toward programs that match their goals.9PubMed Central. Kids into health careers: a rural initiative If your school has a health careers day, a pre-health advisory program, or a partnership with a local nursing school, take advantage of it. These connections can help you understand what specific prerequisite courses your target programs require, since requirements vary.
A Sample Four-Year Plan
Putting it all together, here is what a nursing-focused high school schedule might look like across four years. This is not the only way to do it, and your school’s offerings will dictate what is actually available, but it gives you a concrete starting point.
- Freshman year: Biology, Algebra I or Geometry (depending on where you start), English, a foreign language, and an introductory health science or psychology elective if available.
- Sophomore year: Chemistry, Algebra II or Geometry, English, a foreign language, and a computer applications or keyboarding course.
- Junior year: Anatomy and Physiology (or AP Biology if A&P is not offered), Pre-Calculus or Statistics, English, Psychology or Sociology, and potentially the first course in a CTE health-science pathway.
- Senior year: AP Biology or AP Chemistry (if you have not already taken one), Statistics (if not taken junior year), English, and a CNA certification course or the capstone of your CTE health-science track.
Adapt this framework to your own strengths and school catalog. Not every school offers AP science, and not every student needs pre-calculus. The core principle is to build a strong science and math base in the first two years and use the last two years to deepen that base while adding healthcare-specific experience and electives.
When Your School Does Not Offer Everything
Smaller or under-resourced high schools may not have anatomy and physiology, AP sciences, a CTE health track, or a CNA pathway. That does not put you at a disadvantage if you are strategic. Community colleges frequently offer dual-enrollment anatomy, biology, or medical terminology courses that high school students can take for college credit. Some community colleges also run CNA programs specifically designed for high school juniors and seniors.
Online courses through accredited platforms are another option, particularly for subjects like medical terminology or health informatics that your school is unlikely to teach. Just make sure any online coursework is from an accredited provider and will actually transfer as credit or be recognized by the nursing programs you plan to apply to. A quick email to an admissions office can save you from wasting time on a course that looks impressive but carries no weight.
If none of those options are available, focus on what you can control: take the most rigorous science and math courses your school offers, maintain a strong GPA, read widely about health and science on your own, and seek out clinical exposure through volunteering. Nursing admissions committees understand that not all high schools are created equal. What they want to see is that you made the most of what was available to you.
Classes That Sound Helpful but Are Not Essential
Some students wonder whether they need advanced math like calculus, or whether AP Physics is important. For the vast majority of nursing pathways, the answer is no. Calculus is not required by any standard BSN prerequisite list, and while physics concepts do appear in advanced nursing practice, a dedicated high school physics course is rarely a prerequisite. If you enjoy those subjects, take them. But if you are choosing between AP Physics and a CNA course, the CNA course will serve your nursing career far more directly.
Similarly, some students load up on every AP course available in hopes of looking competitive. For nursing admissions, depth in the right subjects matters more than breadth across unrelated ones. AP Art History and AP European History are fine classes, but they do not strengthen a nursing application the way AP Biology or a health-science elective does. Be strategic rather than exhaustive. Nursing programs want to see that you can handle college-level science, that you understand what nursing involves, and that you have the communication and critical-thinking skills to succeed in a demanding clinical environment.