Nursing school prerequisites typically include a set of college-level science courses, general education classes, a minimum GPA, and an entrance exam. Most programs also require health screenings, background checks, and CPR certification before you start clinical rotations. The exact list varies by school and program type, but the core requirements are remarkably consistent across the country.
Science Courses Form the Foundation
Every nursing program requires a core group of science prerequisites, and most require that these courses include a lab component. The standard list includes:
- Human Anatomy and Physiology I & II: Usually a two-semester sequence covering the structure and function of every major body system. This is the single most important prerequisite and the one programs scrutinize most closely.
- Microbiology: Covers bacteria, viruses, fungi, and how infections spread and are controlled. Nearly universal as a requirement.
- Chemistry: Some programs require general chemistry, others accept introductory or survey-level chemistry. A few BSN programs ask for both general and organic chemistry.
- Nutrition: A standalone course on human nutrition is common, particularly for BSN programs.
These science courses carry extra weight in the admissions process. Many programs calculate a separate science GPA alongside your cumulative GPA, and a strong performance here can make or break your application.
General Education Requirements
Beyond the sciences, nursing programs require a range of general education courses. A typical list includes English Composition (often two semesters), Introduction to Psychology, a statistics course, and sometimes a sociology or human development class. Programs offering a Bachelor of Science in Nursing tend to add requirements like American government or history to fulfill broader university degree standards.
Statistics deserves special attention. It shows up as a prerequisite for nearly every program, and schools are generally flexible about which department offers it. Psychology statistics, sociology statistics, and general elementary statistics courses all tend to satisfy the requirement. Developmental psychology or a course titled Human Growth and Development is another frequent addition, since understanding how people change across the lifespan is directly relevant to patient care.
GPA Standards Are Higher Than You Might Expect
Most nursing programs list a minimum GPA of 2.5 to 3.0 for eligibility, but the GPA of students who actually get accepted is often far higher. At competitive BSN programs, the average admitted GPA regularly lands between 3.5 and 3.9. Some of the most competitive public university programs in states like California report average GPAs of 3.8 to 4.0 among admitted students.
To put specific numbers on it: a 2020 survey of California State University nursing programs found average admitted GPAs of 3.76 at Bakersfield, 3.79 at Fullerton, 3.95 at Long Beach, and 3.99 at Sacramento. Private universities tend to be slightly less extreme but still competitive. Azusa Pacific averaged 3.43, Concordia University around 3.4, and the University of San Francisco 3.8.
Associate Degree in Nursing (ADN) programs at community colleges are generally less competitive on GPA alone, but many use a points-based system where your grades in prerequisite courses, entrance exam scores, and sometimes healthcare experience all factor in. A 3.0 might get you eligible, but a 3.5 or higher makes you a realistic candidate at most schools.
Entrance Exams: TEAS and HESI
Nearly all nursing programs require a standardized admissions test, and the two dominant options are the TEAS (Test of Essential Academic Skills) and the HESI A2 (Health Education Systems Incorporated Admission Assessment). Your school will specify which one it accepts.
The TEAS tests four areas: reading, math, science, and English language usage. It’s designed to measure whether you have the academic foundation to handle nursing coursework. The HESI A2 covers a broader set of subjects, including anatomy and physiology, biology, chemistry, grammar, math, physics, reading comprehension, and vocabulary, though not every program requires all sections.
Benchmark scores vary by school. As a reference point, some programs require at least 78% on all TEAS sections and an overall HESI score of at least 80%. Competitive programs often expect scores well above those minimums. You can retake both exams, though most schools limit how many attempts you get within a given time period.
Health and Immunization Requirements
Before you set foot in a clinical setting, you’ll need to provide documentation of a full slate of immunizations and health screenings. Programs typically require proof of vaccination for Hepatitis B (including a positive blood titer confirming immunity), measles, Tdap (tetanus, diphtheria, pertussis), varicella (chickenpox), and an annual flu shot. Tuberculosis testing, either a skin test or blood test, is also standard.
These requirements aren’t optional or negotiable at most schools, because clinical sites (hospitals, clinics, long-term care facilities) set their own policies and won’t allow unvaccinated students on their floors. You’ll need official documentation from a healthcare provider or immunization registry for each vaccine. If your Hepatitis B titer comes back negative even after the initial vaccination series, you may need a booster dose followed by another titer six to eight weeks later.
Many programs use a third-party tracking service like CastleBranch to manage and verify all health documentation, which typically costs a small fee.
Background Checks and Additional Clearances
A national criminal background check is required by virtually every nursing program. Some states also require a separate state-level background check that must be renewed annually. In Washington State, for example, students must complete a state patrol background check each year at a cost of about $11, along with a disclosure statement regarding any criminal convictions or civil adjudications related to crimes against persons.
Drug screening is another common requirement, usually a urine test completed before your first clinical rotation. Some clinical sites conduct random screenings throughout the program. You’ll also need professional liability insurance for clinical work, which many universities offer through a group policy for around $15 per academic year.
CPR Certification
Current CPR certification is required before you begin clinical coursework. Programs specifically require a course that covers adult, child, and infant CPR with hands-on skills verification. Online-only CPR courses generally don’t count. The certification must be through an American Heart Association-approved provider, and you’ll need to keep it current for the entire time you’re in the clinical portion of the program. If it lapses, you won’t be allowed into clinical sites until it’s renewed.
Science Credits Can Expire
One detail that catches many applicants off guard is that prerequisite science courses have an expiration date. Programs commonly require that anatomy, physiology, microbiology, and chemistry courses have been completed within the last five to ten years. The exact window depends on the school, and it’s rarely posted prominently, so you need to ask directly.
As a general rule, STEM courses older than ten years are unlikely to transfer or satisfy prerequisites. Many nursing programs draw the line at five or seven years for sciences specifically, reasoning that medical knowledge evolves quickly. If you took anatomy twelve years ago and earned an A, you may still need to retake it. Check with each program early in your planning so you don’t discover this at the application stage.
ADN vs. BSN Prerequisite Differences
Associate Degree in Nursing programs, typically offered at community colleges, require fewer total prerequisites because the degree itself is shorter. You’ll still need the core sciences and usually English composition, psychology, and statistics, but the general education load is lighter.
BSN programs at four-year universities layer on additional general education courses like sociology, human development, American history or government, and sometimes a second English course. They may also require a higher-level chemistry or an additional elective in the social sciences. The tradeoff is that a BSN opens more career doors and is increasingly preferred or required by hospitals.
Accelerated BSN programs, designed for students who already hold a bachelor’s degree in another field, still require the same science prerequisites. The “accelerated” part refers to the nursing coursework, not the prerequisites. You’ll need anatomy, physiology, microbiology, statistics, and nutrition completed before you start, regardless of what your first degree was in.