What Are the Hardest Classes in Nursing School?

hardest classes in nursing school

Nursing school presents intensive demands across the board. However, specific courses stand out as particularly rigorous obstacles in the curricula. Examining the most notoriously tricky classes and tips for conquering them helps students prepare strategic study plans. This guide explores nursing education’s ultimate challenges.

Hardest Prerequisite Nursing Courses

Before admission into core nursing coursework, prerequisite science classes pose steep initial challenges, including:

Anatomy and Physiology (1&2)

This 2-term sequence explores the bodily structural formations alongside complex integrated functional processes. Students must memorize anatomical components – grossly exceeding average recall abilities – while developing comprehension of physiological mechanisms.

For example, A&P thoroughly dissects the numerous constituents of organ systems, like the hundreds of renal structures facilitating urine production. Learners must then incorporate more profound realizations of filtration and regulatory phenomena.

The enormous memorization capacities and conceptual grasp abilities required across two lengthy course sequences become a challenge to students. The fast-paced delivery and testing over hundreds of specifics rather than broad concepts also overwhelms undergraduates. Many switch out of pre-nursing.

Organic Chemistry

This demanding prerequisite class examines the multidimensional properties dictating carbon molecule bonding essential for appreciating biochemistry. Thus, pre-nursing students tackle confusing 3-dimensional compound representations and chemical formula math unrelated to patient care skills.

For instance, topics span reaction mechanisms producing specific functional groups, kinetics rate laws regarding activation energies, and catalysis processes enabling biological reactions. Many students without recent chemistry backgrounds struggle to grasp such concepts fully.

Additionally, the common pairing with weekly lab components assessing hands-on experimental technique applications poses substantial stakes toward final grades. Simply memorizing equations or structural names fails to demonstrate competencies. This combination frustrates many without past chemistry interests.

What is the Hardest Class in Nursing School?

Upon acceptance into nursing primary course sequencing, the following upper-level classes represent the most prevalent academic obstacles students meet:


Learning about pathophysiology in nursing school bridges understanding normal physiology with disease process derivations using foundational science preparation from earlier coursework. Making connections between established organic functioning and intricate failing pathology poses comprehension challenges. The clinical application also relies on solid anatomy knowledge retention.


This lesson concentrates on pharmacological interventions for managing primary conditions using various drug classes and therapies. Memorizing seemingly endless lists of medications, mechanisms of action, dosages, onset/durations, clearance rates, contraindications, side effects, and nursing considerations taxes students enormously. Plus, accurately prescribing interventions demands intellectually integrative clinical decision-making abilities. Students find learning and applying so many drugs across varied contexts extremely frustrating.

Medical Surgical 1 (also known as Adult Health 1)

Often called Adult Health Nursing, this pivotal course interweaves an understanding of pathophysiology, pharmacology, health assessment, nursing skills, and direct patient care delivery for adults experiencing acute major illnesses, chronic diseases, or perioperative needs. The extensively integrative nature spanning vast bodily systems and conditions overwhelms many students transitioning from broader foundational topics. Managing hypothetical patients in such compromised states also intensifies critical thinking requirements exponentially compared to earlier coursework.

Evidence-Based Practice

This class evaluates the hierarchy of credibility, strengths, and limitations of various clinical research methodological approaches. Students learn grading systems for appraising external study designs, statistical significance measurements, and strength of scientific findings to determine optimal interventions they should implement for future patients. Contrasting more concrete health assessment or technology skills training, these high-level critical analysis concepts prove intellectually challenging.


This course examines minute pathogen structures, transmission variables, intricate immune response mechanisms, and actions of antibiotic or antiviral agents from a biochemical lens. As this cellular-level content resides outside typical bedside nursing duties, students find practical application lacking despite memorizing elaborate microbial science. The depth also frustrates students who narrowly pass prerequisite courses.

Ways To Prepare and Succeed In The Hardest Courses In Nursing School

The following evidenced-based strategies help students successfully conquer the most notoriously tricky lessons:

Break it down – Simplify complex topics like heart failure pathophysiology into understandable segments, focusing on one concept comprehensively before linking ideas. Chunking prevents overwhelm.

Make flashcards – Craft endless online/paper flashcard decks encompassing must-know terminology, drug names/groups, diseases, lab values, etc., for portable testing. Interactive studying strengthens memory.

Learn prefixes, suffixes, and word roots – Improving medical vocabulary skills via word part analysis and dissecting the etymology of unfamiliar terms exponentially boosts the ability to decode complex lessons by unlocking definitions.

Develop critical thinking – Practice explaining rationales for assessments, prioritization, and interventions to realistically complex case studies. Verbalizing clinical judgment abilities sharpen skills.

Get creative – Relate extremely challenging ideas like coagulation cascades using clever memory devices, songs, acronyms, rhymes, etc. Cementing dry memorization facts via engaging mediums promotes recall.

Form study groups – Verbal conveying challenging concepts to peers mutually reinforces comprehension strengths better than solo attempts. Help each other unpack dilemmas.

Consider relevance – When overwhelmed, visualizing the conveyance of a concept like pharmacology enabling proper future medication administration inspires perseverance despite temporary discomforts. Remember the “why”.

Prepare before class – Preview assigned textbook chapters to establish foundations. Then, lectures refine understandings instead of acting as overwhelming introductory data dumps. Come informed and ready to clarify uncertainties.

Master time management – Strategically balance intensive studying with adequate sleep, nutritious eating, and exercising to prevent burnout. Failing to integrate self-care sabotages retention abilities.

Know your teachers – Cultivate approachable connections with faculty willing to reteach complex topics in varied ways if initially confused. Ask questions freely.

Review practice questions and past tests – Investigating all practice problems and test item response rationales uncovers nuanced clinical perspectives. Probe the “why” behind right and wrong answers.

Are All Nursing Classes Hard?

While intense overall, secondary to condensed formats and clinical skills preparation requirements, specific general education, care management, and ethics courses integrate more intuitively with students’ developing patient abilities. These pose less strain on recalling intricate science concepts from earlier coursework. However, foundational classes and advanced lessons uniquely tax capacities.

Thinking About Going to Nursing School?

The most notoriously difficult courses in nursing school share commonalities of prerequisite assumptions, intellectually demanding critical thinking applications, staggering memorization volumes, and challenging human limitations.

Yet what separates nursing students who give up when curriculums seem unconquerable from those who persist in deliberately harnessing versatile evidence-based learning strategies and lifestyle balance tactics? Commit to the temporary academic discomfort, knowing it prepares you for the sacred calling. You’ve got this!

Out of All The Classes, What Is The Hardest Nursing Class?

Medical surgical nursing and pharmacology are the most difficult overall in preparing BSN students for the realities of complex patient medication regimens and interventions across multifaceted conditions. The integrative nature stands out as highly demanding.

What Hardest Nursing Class Is The Most Important?

As fundamentals for applied practice, medical surgical nursing and pharmacology are essential for safe clinical performance. Grasping these creates competence.

On Average, How Much Do Nursing Students Score In The Hardest Nursing Classes?

Passing notoriously difficult courses like pharmacology and medical-surgical nursing requires tenacious devotion. Expect average exam scores around the low 80s to upper 70s. C+ averages that meet passing cutoffs prevail.

Can I Choose To Skip A Nursing Class Because It Is Hard?

No. Accredited nursing programs mandate completion of all specified courses to graduate and qualify for RN licensing exam sitting. Skipping classes results in automatic failure, halting advancement.

What Should I Do If I Fail a Hard Nursing Class?

Failing pivotal classes delays progress significantly but doesn’t necessitate surrendering nursing dreams fully. Analyze preparatory shortcomings, improve strategies, and boldly try again next term. Many prevail on second attempts. Discuss options with advisors compassionately supporting persistence.

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