Most nursing programs require a core set of science courses, general education classes, a competitive GPA, and several non-academic requirements like background checks and immunizations before you can start. The exact list depends on whether you’re pursuing an associate degree (ADN) or a bachelor’s degree (BSN), but the foundation is largely the same across programs.
Science Courses Form the Core
Every nursing program requires a set of science prerequisites, and these are the courses admissions committees scrutinize most closely. At minimum, you’ll need:
- Anatomy and Physiology I and II: Two semesters covering the structure and function of the human body. These are the backbone of your nursing education.
- Microbiology: Covers bacteria, viruses, and immune responses, all directly relevant to infection control in clinical settings.
- Chemistry with lab: Typically General Chemistry I or Inorganic Chemistry. The course needs to be a four-credit class that includes a lab component. Chemistry courses designed for non-science majors usually aren’t accepted, and Organic Chemistry or Biochemistry won’t substitute for the general chemistry requirement.
Some programs also require a general biology course, especially at the ADN level. BSN programs tend to add pathophysiology (how diseases disrupt normal body function) either as a prerequisite or as part of the nursing curriculum itself.
One important detail many applicants overlook: science prerequisites can expire. Many programs require that your science courses were completed within five to seven years of your program start date. General education credits like English and history typically don’t expire, but if you took Anatomy and Physiology a decade ago, you’ll likely need to retake it. Check your target school’s specific policy before assuming old coursework will transfer.
General Education Requirements
Beyond the sciences, nursing programs require a range of liberal arts and social science courses. BSN programs have a longer list than ADN programs because they’re four-year degrees with broader curriculum expectations. A typical BSN prerequisite list includes:
- English Composition I and II: Two semesters of college-level writing.
- Statistics: Either a general statistics course or psychology statistics. This prepares you to interpret research in evidence-based nursing practice.
- Psychology: An introductory course, and often a second course in human growth and development covering the full lifespan from conception through death.
- Sociology: An introductory course covering social structures and group behavior.
- Philosophy or Ethics: Sometimes listed as a language, philosophy, and culture requirement.
- Humanities electives: Visual and performing arts, history, or government courses depending on the institution.
ADN programs at community colleges require fewer general education courses. The core prerequisites still include psychology, English, and statistics, but you won’t typically need history, government, or philosophy. This is the main reason an ADN can be completed in two years (sometimes 18 months in accelerated formats) compared to four years for a BSN.
GPA Expectations
Nursing programs are competitive, and your GPA in prerequisite courses matters as much as, or more than, your overall GPA. Most programs set a minimum cumulative GPA around 2.8 on a 4.0 scale, with a 3.0 minimum in your pre-nursing coursework specifically. Some accelerated BSN programs accept a cumulative GPA as low as 2.4 for initial admission, but expect a 3.0 in the program itself.
If you’re applying straight out of high school to a direct-admission BSN program, the bar is higher. These programs, which guarantee your spot in the nursing school from day one, often require an unweighted high school GPA of 3.5 or above. Meeting the published minimum doesn’t guarantee admission either. At competitive programs, admitted students often have GPAs well above the stated floor, particularly in science courses. A C in Anatomy and Physiology, even if it technically meets the minimum, can put you at a disadvantage.
Nursing Entrance Exams
Most programs require you to take a standardized entrance exam as part of your application. The two most common are the TEAS (Test of Essential Academic Skills) and the HESI A2 (Health Education Systems Incorporated Admission Assessment). Your school will specify which one they accept.
The TEAS covers four sections: reading, math, science, and English language usage. The HESI A2 tests math, reading, vocabulary and grammar, and anatomy and physiology, with some schools adding extra sections. Passing requirements vary by program. Some set minimum scores for each individual section, while others evaluate your overall composite score. Neither exam tests nursing knowledge directly. They’re measuring whether you have the academic foundation to handle nursing coursework.
You can take both exams multiple times, though many schools limit retakes to two or three attempts per year. Study guides and practice tests are widely available, and spending a few weeks preparing, especially on the science sections, can make a meaningful difference in your score.
ADN vs. BSN: How Prerequisites Differ
The science prerequisites are essentially the same for both ADN and BSN programs. Where they diverge is in the volume of general education coursework. An ADN focuses tightly on clinical nursing skills: fundamentals, medical-surgical nursing, pediatric nursing, psychiatric nursing, and community health. You complete fewer liberal arts courses and get into clinical training faster.
A BSN covers all of that plus theoretical nursing concepts, public health, nursing ethics, and research methods. It provides broader training and more extensive clinical experience. The tradeoff is time and cost: two years at a community college versus four years at a university. Many nurses start with an ADN and later complete an RN-to-BSN bridge program while working, which is worth considering if cost or time is a constraint.
Accelerated BSN for Career Changers
If you already hold a bachelor’s degree in a non-nursing field, accelerated BSN programs let you earn your nursing degree in roughly 12 to 15 months. You won’t repeat general education courses. Your existing degree satisfies those requirements. However, you’ll still need the science prerequisites: anatomy and physiology, microbiology, and chemistry. If your previous degree was in biology, kinesiology, or another science-heavy field, many of those credits will transfer, provided they fall within the program’s recency window (typically seven years for science courses). If your degree was in English or business, expect to spend one to two semesters completing science prerequisites before starting the accelerated program.
Non-Academic Requirements
Before you set foot in a clinical setting, you’ll need to clear several non-academic hurdles. These aren’t optional, and missing even one can delay your start date.
Background check. Every nursing program runs a criminal background screening. In many states, this is an FBI-level check required by the state board of nursing. You cannot enroll in nursing courses until you receive clearance. Some clinical sites where you’ll complete your training may run their own additional checks.
Drug screening. Clinical agencies frequently require drug tests. A positive result will prevent you from participating in clinical courses, which effectively pauses your entire program. Policies are strict: a positive screen at some schools results in a minimum one-year suspension and requires documentation of completed treatment before readmission.
CPR certification. You need a current healthcare-level CPR certification before your first nursing class. Only specific certifications count: American Heart Association BLS for Healthcare Providers or American Red Cross CPR/AED for Professional Rescuers and Health Care Providers. A standard community CPR class won’t qualify. You’ll also need to keep this certification current throughout the program.
Immunizations. Requirements vary by state, but nursing students are generally expected to be up to date on Hepatitis B, MMR (measles, mumps, rubella), varicella (chickenpox), influenza (annually), and Tdap (tetanus, diphtheria, pertussis). Some states mandate these for all healthcare workers by law, while others require that hospitals offer them. Your program will give you a specific checklist, and you may need to show proof of immunity through blood titers rather than just vaccination records.
Physical health clearance. Programs require that students can meet the essential physical and mental demands of nursing practice. You may need to sign a statement confirming you can perform tasks like standing for long periods, lifting patients, and responding to emergencies. A provider’s clearance may be required if you experience a health issue during the program.
Planning Your Timeline
If you’re starting from scratch with no college credits, expect to spend one to two years on prerequisites before applying to a nursing program. Many students complete prerequisites at a community college to save money, then transfer into a BSN program. This is a well-established path, but verify that your target nursing school accepts transfer credits from the institution where you plan to take them.
A practical approach is to start with anatomy and physiology and chemistry, since these are the most demanding courses and carry the most weight in admissions decisions. Layer in general education courses around them. Take your entrance exam (TEAS or HESI A2) toward the end of your prerequisite work, when the science content is fresh. Build in time for the non-academic requirements, since background checks and immunization records can take weeks to process. Programs have hard deadlines, and submitting a late document can cost you a semester.