Getting into nursing school requires a combination of strong prerequisite coursework, a competitive GPA, a passing score on an entrance exam, and a well-prepared application. The process is competitive: in 2024, over 80,000 qualified applications were turned away from nursing programs nationwide, largely due to limited clinical placement sites, faculty shortages, and space constraints. Knowing exactly what’s required at each step gives you a real advantage.
Pick the Right Program Type
Not all nursing programs lead to the same credential, and choosing the wrong one can cost you time. There are three main entry points into nursing, each with a different timeline and outcome.
A Licensed Practical Nurse (LPN) program takes about one year and prepares you for basic patient care under the supervision of registered nurses and doctors. It’s the fastest path into bedside work, but it limits the roles you can fill and the settings you can work in.
An Associate Degree in Nursing (ADN) typically takes two to three years and results in an entry-level college degree. Graduates sit for the same licensing exam as BSN graduates and become registered nurses, though some hospitals increasingly prefer or require a bachelor’s degree.
A Bachelor of Science in Nursing (BSN) takes about four years and opens the widest range of career options, including leadership roles, public health, and graduate school. If you already hold a bachelor’s degree in another field, accelerated BSN programs can get you there in 12 to 18 months.
Complete Your Prerequisite Courses
Every nursing program requires a set of science and general education courses before you can apply. While the exact list varies by school, most programs pull from the same core. Expect to complete anatomy and physiology, microbiology (with a lab component), a chemistry course covering general, organic, and biochemistry fundamentals, a nutrition course, and a psychology course, often developmental or health psychology. English composition and a statistics or math course round out the general education side.
These prerequisites aren’t just checkboxes. Your grades in them heavily influence whether you’re admitted. At Texas State University, for example, accepted BSN students in 2025 had an average prerequisite GPA of 3.78 and an average science GPA of 3.57. Many programs set a minimum GPA around 2.75 or 3.0 just to apply, but the students who actually get in are well above that floor. If you earn a C in anatomy or microbiology, strongly consider retaking it before applying.
Take science prerequisites at a four-year institution when possible. Some programs won’t accept certain courses from community colleges, particularly pathophysiology. Check your target school’s transfer policies before enrolling anywhere.
Prepare for the Entrance Exam
Most nursing programs require either the ATI TEAS or the HESI A2 exam. A few accept both, but you’ll typically need to find out which one your target school uses and focus your prep accordingly.
The ATI TEAS is a 170-question exam lasting about three and a half hours. It covers four sections: reading (64 minutes), math (54 minutes), science (63 minutes), and English and language usage (28 minutes). Many programs require a minimum composite score of around 75%, though competitive applicants score higher. The science section sometimes has a lower threshold, around 58% to 60%, reflecting its difficulty.
The HESI A2 is a four-hour exam that can cover reading comprehension, vocabulary, grammar, basic math, biology, chemistry, and anatomy and physiology. Not every school requires all sections. Passing scores vary, but some programs set the bar at 85% or higher in each required section, which means you need genuine content mastery, not just test-taking skill.
Both exams test material you’ve already covered in your prerequisites. The most effective preparation strategy is to study content alongside official practice tests so you can identify weak areas early. Budget at least four to six weeks of focused prep time.
Build a Competitive GPA
Your GPA is the single most important number in your application. Programs typically evaluate two separate GPAs: your cumulative GPA across all college coursework and your science GPA, which isolates your performance in biology, chemistry, anatomy, and related courses.
To put real numbers on this, admitted students at Texas State’s nursing program in 2024 averaged a 3.77 prerequisite GPA and a 3.50 science GPA. Those numbers climbed slightly the following year. A 3.5 overall GPA is a reasonable target if you’re aiming for a competitive BSN program, but at highly selective schools, you’ll want to be closer to 3.7 or above.
If your GPA is below the competitive range, you have options. Retaking prerequisite courses (where the school allows grade replacement), completing additional upper-level science courses to demonstrate improvement, or starting with an ADN program and bridging to a BSN later can all strengthen your profile.
Assemble Your Application
Some nursing programs use a centralized application service called NursingCAS, which works similarly to the common application for undergraduate admissions. You submit your transcripts, test scores, and personal materials through a single portal, and NursingCAS verifies and delivers them to your chosen programs. Each school sets its own deadline within the system, so check individual program pages carefully. Transcript verification can take weeks, so submit materials well before the deadline rather than the day of.
Other programs, particularly community college ADN programs, handle applications independently through their own admissions offices. Either way, you’ll generally need to provide official transcripts from every college you’ve attended, your entrance exam scores, a personal statement, and letters of recommendation.
Letters of Recommendation
Most programs ask for two or three letters. The strongest letters come from people who can speak to qualities that matter in nursing: nursing professors or science instructors who’ve seen your academic ability, clinical supervisors or preceptors who’ve observed you with patients, or volunteer coordinators from healthcare settings. An employer outside of healthcare can still write an effective letter if they can speak specifically to your reliability, communication skills, teamwork, and problem-solving ability.
When you ask someone to write for you, give them at least three to four weeks and provide a brief summary of your goals, the programs you’re applying to, and specific examples they could reference. Admissions committees look for concrete stories about empathy, critical thinking, resilience, and leadership rather than generic praise.
Personal Statement
Your personal statement should explain why nursing specifically, not just why you want to help people. Connect your experiences, whether clinical, volunteer, or personal, to the specific skills and values the profession demands. Programs want to see that you understand what nursing actually involves and that you’ve tested that understanding through real exposure to healthcare settings.
Clear Background and Health Requirements
Before you begin clinical rotations, and sometimes before admission, nursing programs require criminal background checks and drug screenings. Clinical sites affiliated with hospitals and accreditation bodies like the Joint Commission mandate these checks, and results can directly affect your ability to complete the program.
Prior convictions don’t automatically disqualify you, but they may limit which clinical sites will accept you. If no site is available, it can delay or prevent your graduation. It’s also worth knowing that even after completing a nursing program, state licensing boards conduct their own review, and certain criminal histories can block licensure entirely. If you have concerns, contact your state board of nursing before investing in a program.
Drug testing follows similar rules. A positive result for non-prescription substances, including cannabis even in states where it’s legal, can result in removal from a clinical site. Programs may not always be able to place you at an alternative location, which could extend your time in school or halt your progress.
Health requirements typically include proof of up-to-date immunizations (hepatitis B, MMR, varicella, flu, COVID-19, and a tuberculosis screening), a physical exam, and current CPR certification.
Prepare for an Interview
Not all programs interview applicants, but competitive BSN programs increasingly do. Some use traditional panel interviews with faculty members. Others use a format called the Multiple Mini Interview, or MMI, where you rotate through a series of short stations, each presenting a different scenario. At each station you read a prompt on the door, get about two minutes to collect your thoughts, then spend roughly eight minutes discussing your response with an assessor who asks scripted follow-up questions.
MMI scenarios test how you think through ethical dilemmas, communicate under pressure, and respond to situations involving conflict, teamwork, or patient care. There’s no single right answer. Assessors are evaluating your reasoning process, your ability to consider multiple perspectives, and how clearly you articulate your thinking. Practicing with a friend or recording yourself answering behavioral questions (“Tell me about a time you handled a conflict” or “How would you respond if you saw a coworker cutting corners?”) is the most effective preparation.
Strengthen a Weaker Application
If your GPA or test scores fall below the competitive range, other parts of your application can make a difference. Healthcare experience, whether as a certified nursing assistant, EMT, medical assistant, or volunteer, demonstrates that you understand the realities of patient care. Community service, particularly in health-related settings, shows commitment beyond academics.
Applying broadly also helps. With over 80,000 qualified applications rejected in 2024 alone, even strong candidates benefit from applying to multiple programs. Consider a mix of reach schools and programs where your stats fall comfortably within the admitted range. ADN programs at community colleges are often less competitive on GPA alone and provide a viable path to RN licensure, with the option to complete an RN-to-BSN bridge program later while working.