Anatomy and physiology is the single most important subject to review before nursing school, and the research on this is remarkably consistent. Studies tracking first-year nursing students find that grades in anatomy and physiology courses are the strongest predictors of overall academic success, outweighing every other prerequisite. But A&P is not the only area that deserves your attention. Math skills, reading comprehension, basic microbiology, and medical terminology all feed directly into the coursework you will face from day one, and gaps in any of them can make a demanding program feel overwhelming.
Why Anatomy and Physiology Matters Most
If you have time to review only one subject, make it anatomy and physiology. A cluster analysis of first-year nursing students found that A&P grades were consistently the strongest predictors of which students ended up in the high-achieving group versus the low-achieving group, and recommended that A&P courses receive extra weighting in any GPA calculation because of their outsized influence on overall performance.1PubMed. Introductory anatomy and physiology in an undergraduate nursing curriculum Separate research using regression modeling confirmed that A&P test scores significantly predicted success in clinical nursing coursework.2PubMed. Anatomy and physiology as a predictor of success in baccalaureate nursing students
This is not just an academic correlation. When nursing students themselves were surveyed, over 90% agreed that every nurse needs a solid understanding of A&P. They recognized it as the foundation for understanding what goes wrong in a patient’s body, for making meaningful observations, for choosing treatments, and for keeping patients safe.3BioMed Central. Integration of anatomy and physiology into nursing practice as perceived by undergraduate students and registered nurses: a scoping review In other words, this is not just a hoop to jump through. A&P is the lens through which you will interpret nearly everything else in nursing school.
So what specifically should you review? You do not need to memorize every bone and muscle before orientation. Focus on the major organ systems and their basic functions: how the cardiovascular system moves blood, how the respiratory system exchanges gases, how the kidneys filter waste, and how the nervous system coordinates it all. If you took A&P a year or more before starting nursing school, the material has likely faded more than you think. A refresher textbook, an anatomy app, or even a well-structured YouTube series can bring the essentials back. Pay extra attention to the areas students find hardest. The same scoping review that found such high appreciation for A&P also identified the nervous system, the kidneys and urinary tract, and acid-base balance as the topics students struggled with most.3BioMed Central. Integration of anatomy and physiology into nursing practice as perceived by undergraduate students and registered nurses: a scoping review If those topics feel shaky, they are worth extra time.
Math Skills for Medication Safety
Nursing math is not calculus. It is fractions, decimals, ratios, unit conversions, and proportional reasoning, the kind of math most people learned in middle school and then slowly forgot. The trouble is that in nursing, getting these calculations wrong is not an abstract problem. Medication dosage errors can directly harm patients, and research consistently finds that nursing students arrive underprepared. One study measuring basic mathematical competencies in baccalaureate nursing students found a low median score, underscoring what the authors called a critical need for intervention to protect medication safety.4PubMed Central. An Indispensable Requirement for Medical Dosage Calculation: Basic Mathematical Skills of Baccalaureate Nursing Students
Making things worse, many students carry genuine anxiety around math that compounds the difficulty. A systematic review of medication dosage assessment anxiety found that it often stems from students’ personal histories and prior negative experiences with math, not from any inherent difficulty of the calculations themselves. The review also found that interventions focused on building self-efficacy, basically, helping students believe they could do the math, improved actual performance on assessments.5PubMed. Medication math dosage assessment anxiety in undergraduate nursing students: A systematic review
Before nursing school, practice the following until they feel automatic:
- Unit conversions: milligrams to grams, milliliters to liters, pounds to kilograms. You will do these constantly when calculating drug doses.
- Fractions and decimals: dividing, multiplying, and converting between the two. Tablet-splitting and IV drip rate problems depend on this.
- Ratio and proportion: if the vial contains 250 mg in 5 mL, how many mL do you draw for a 100 mg dose? This is the bread and butter of dosage calculation.
- Percentages: understanding what a 0.9% saline solution actually means, for instance.
Free dosage calculation practice sets are widely available online and through nursing prep publishers. Even 15 minutes a day for a few weeks before school can make a real difference. The goal is not mastery of complex problems but comfort with the basics so that you are not learning arithmetic and pharmacology at the same time.
Reading Comprehension Is the Sleeper Subject
Most people preparing for nursing school think in terms of science and math. They rarely think about reading as a subject to review. But data from nursing entrance exams tells a different story. A large study analyzing scores on the TEAS (Test of Essential Academic Skills) found that among the four content areas tested, reading was the strongest predictor of performance in the Fundamentals of Nursing course. Science came second, then English language usage, then math. Reading scores alone accounted for the largest share of the predicted change in Fundamentals grades.6PubMed Central. Predictive Validity of Preadmission Assessment on Early Nursing Academic Readiness Impact of COVID-19
This makes sense when you think about what nursing school actually demands. You will be reading dense textbook chapters, parsing clinical guidelines, interpreting care plans, and deciphering physician orders. All of that depends on being able to extract specific information from complex written material quickly and accurately. If you find that you tend to skim rather than absorb, or that you struggle with passages full of unfamiliar vocabulary, practicing active reading strategies before school starts will pay off more than you might expect.
Reading in nursing is made harder by the sheer volume of unfamiliar terminology. Medical language draws heavily on Latin and Greek roots, and students who learn to decode those roots gain a major advantage. An educational study testing an inquiry-based approach to learning medical terminology through prefixes, suffixes, and root words found that nearly 80% of participants had already applied what they learned to their clinical practice, and a majority felt it directly helped them on the job.7Teaching and Learning in Nursing. Roots, prefixes, and suffixes: decoding medical terminology using an online enquiry-based learning intervention for nursing associates You do not need a formal course. Learning a few dozen common roots, like “cardio” for heart, “hemo” for blood, “nephro” for kidney, “hepato” for liver, “pulmo” for lung, gives you a scaffold for breaking down words you have never seen before. Flash cards, apps, or even a simple list taped to your bathroom mirror can build this vocabulary gradually.
Microbiology and Infection Control
Microbiology might seem like a niche prerequisite, but it is directly relevant to some of the most common tasks you will perform as a nurse. A survey of practicing nurses found that the microbiology topics they considered most relevant to their day-to-day work were infection control, hospital-acquired infections, disease transmission, and the collection and handling of patient specimens.8PubMed Central. Microbiology Education in Nursing Practice These are not obscure laboratory skills. Hand hygiene protocols, catheter care, wound infection prevention, and understanding why a patient’s blood culture came back positive all require a working knowledge of how microorganisms behave.
Before nursing school, focus your review on the big-picture concepts rather than memorizing species names. Understand the basic differences between bacteria, viruses, fungi, and parasites. Know how infections spread: contact, droplet, airborne, and fecal-oral routes. Learn what the chain of infection is, because you will hear about it repeatedly. And get comfortable with the idea of normal flora, the bacteria that live on and in healthy people and only cause trouble under certain conditions. This foundational understanding will make your formal microbiology coursework and your clinical infection control training click much faster.
What Nursing Entrance Exams Tell You About Priorities
If you are not sure where your gaps are, the content areas tested on nursing entrance exams offer a useful map. The TEAS and the HESI A2 are the two most widely used admissions tests, and research on both consistently shows that their scores predict first-semester success. One study found that both preadmission GPA and TEAS composite scores significantly predicted whether students passed their health assessment and foundations courses.9PubMed. Preadmission predictors for first semester course success in a baccalaureate nursing program Similarly, research on the HESI A2 found that composite scores and nearly all individual component scores were significantly related to grades in first-semester nursing courses, and that students who completed all three first-semester courses had meaningfully higher A2 scores than those who did not complete one or more.10Journal of Professional Nursing. HESI Admission Assessment Scores: Predicting Student Success
The takeaway is practical. Both exams test reading, math, science, and English or grammar skills. If you plan to take one of these exams, use its study guide as a diagnostic tool. Areas where you score low are the areas where pre-study will have the highest return. And even if your program does not require an entrance exam, the content areas these tests cover, reading comprehension, basic science, math, and English, represent the academic foundation that nursing faculty have found most predictive of student success. Reviewing those areas is not just exam prep. It is nursing school prep.
Pharmacology Foundations
Pharmacology is one of the most challenging courses in any nursing program, and it is one of the few subjects where students benefit from having reviewed adjacent material beforehand rather than the subject itself. You will not be expected to know drug classes on day one, but you will be expected to understand the biology and chemistry that make pharmacology make sense. Nursing education researchers have argued that programs should do more to integrate the theory of medication management, health assessment, and clinical reasoning earlier in the curriculum, acknowledging that current pre-registration programs often leave students underprepared in these areas.10Journal of Professional Nursing. HESI Admission Assessment Scores: Predicting Student Success
What does this mean for your pre-study? A basic understanding of how the body absorbs, distributes, metabolizes, and eliminates drugs helps enormously. This loops back to anatomy and physiology: knowing that the liver processes most medications and the kidneys excrete them makes drug interactions and dosing adjustments intuitive rather than arbitrary. Understanding the autonomic nervous system, the difference between sympathetic and parasympathetic responses, gives you the framework for an enormous number of drug classes. And being comfortable with the math described earlier means you can focus on understanding the drug rather than panicking over the calculation.
Digital Literacy and Technology
Modern nursing involves constant interaction with technology. Electronic health records, medication barcode scanning, patient monitoring systems, and telehealth platforms are all standard in most clinical settings. A cross-sectional study of nursing students found a significant positive relationship between digital literacy and clinical decision-making ability, with digital competency accounting for roughly 15% of the variation in clinical decision-making scores.11BioMed Central. The relationship between digital literacy and clinical decision-making skills among student nurses: a cross sectional study
You do not need to learn any specific electronic health record system before school. What helps is general comfort with technology: navigating software interfaces, understanding basic data privacy principles, using search functions efficiently, and typing at a reasonable speed. If you have been away from academic or office settings for a while, practicing with spreadsheets, word processing, and online databases can reduce the learning curve when clinical software is introduced. Some students also find it useful to familiarize themselves with reliable health information databases like PubMed, since evidence-based practice assignments often require searching the literature.
Ethics Awareness
Nursing school does not just teach you what to do for patients; it teaches you how to think through situations where the right course of action is not obvious. Ethical reasoning is woven throughout the curriculum, and students who arrive with even a basic framework tend to engage with clinical scenarios more effectively. A study of nursing students found a moderate positive correlation between ethical sensitivity and perceived clinical decision-making competence, with ethical sensitivity serving as a significant predictor of how capable students felt in making clinical decisions.12PubMed. Ethical sensitivity and perceived clinical decision-making competence among nursing students: A descriptive and correlational study
You do not need to study bioethics formally before nursing school, but spending some time thinking about common ethical principles in healthcare is worthwhile. The four pillars you will encounter repeatedly are autonomy (respecting the patient’s right to make their own decisions), beneficence (acting in the patient’s best interest), nonmaleficence (avoiding harm), and justice (distributing care fairly). Reading a few case studies involving informed consent, end-of-life decisions, or patient confidentiality can help you start developing the habit of analyzing situations through these lenses. This is not about knowing the “right answer” to every ethical dilemma. It is about getting comfortable with the process of reasoning through competing values, which is something nursing school expects from the start.
Study Habits and Test-Taking Strategies
The volume and pace of nursing school catches many students off guard, even those who did well in their prerequisite courses. The material is not always harder than what you studied before, but there is more of it, and the testing style is different. Nursing exams frequently use application-level questions that require you to apply knowledge to a clinical scenario rather than simply recall a fact. A study of novice nursing students found that scores on measures of anxiety management, concentration, information processing, motivation, and test-taking strategy all significantly predicted academic performance.13Nurse Educator. Self-Regulated and Strategic Learning Practices as Predictors of Academic Performance in Novice Nursing Students
Before school starts, honestly assess your study habits. Do you tend to re-read notes passively, or do you actively quiz yourself? Research on learning consistently shows that retrieval practice, testing yourself on material rather than just reviewing it, produces stronger long-term retention. Do you space your studying out, or do you cram the night before? Spaced repetition beats cramming for the kind of cumulative knowledge nursing demands. Can you manage test anxiety, or does it derail your performance? If anxiety is a pattern for you, developing coping strategies now, whether through breathing exercises, structured preparation routines, or professional support, is a better investment than reviewing one more chapter of anatomy.
Building these habits before school starts means you can focus on learning nursing content rather than simultaneously trying to overhaul how you study. Many programs offer orientation workshops on study strategies, but arriving with a deliberate approach already in place gives you a head start.
Managing Stress and Building Resilience
Nursing school is genuinely stressful. Clinical rotations put you in emotionally intense situations. Exams come at a relentless pace. Many students work jobs or manage family responsibilities alongside their coursework. A systematic review of resilience-building interventions in nursing education found that programs combining information sharing, skill application, and reflective learning were effective at helping students manage stress and increase resilience.14PubMed. Fostering Resilience in Nursing Students in the Academic Setting: A Systematic Review
The practical implication is that resilience is not just a personality trait you either have or lack. It can be developed. Before nursing school, consider establishing routines that will serve as your foundation when things get hard. Regular exercise, consistent sleep habits, a social support network you can lean on, and a realistic plan for managing your time are all more valuable than squeezing in one more A&P review session. Some students find journaling or mindfulness practices helpful; others prefer talking through stress with friends or family. The specific strategy matters less than having one in place before the pressure starts. Students who enter nursing school already knowing how they will handle difficult weeks are far less likely to burn out than those who assume they will figure it out along the way.
Topics That Can Wait
It is easy to feel like you should try to learn everything before school starts, but some subjects are better left for the structured curriculum. Advanced pharmacology, for instance, builds sequentially through your program and assumes the physiology and math foundations are already there. Trying to learn drug classes out of context can create more confusion than clarity. Similarly, clinical skills like inserting IVs, performing assessments, or charting in electronic health records are taught with supervised hands-on practice that cannot be replicated from a textbook at home.
Nursing theory and the nursing process (assessment, diagnosis, planning, implementation, evaluation) are also better learned within the program’s framework. These concepts are specific to nursing education and are taught with a particular pedagogical approach that your faculty will have designed around clinical application. Reviewing a basic overview is fine, but trying to deeply study these frameworks on your own risks learning them incorrectly or out of alignment with how your program teaches them.
The same applies to specific disease processes and pathophysiology. You will study these extensively in school, and the teaching is designed to build on your A&P foundation. If your A&P is solid, pathophysiology will make sense. If your A&P is shaky, no amount of pre-studying disease processes will compensate. Put your time where it matters most: the foundational knowledge that everything else rests on.