Literacy is complex and impacts safety in nursing. When using language, nurses are constantly switching between medical language proficiency, academic language proficiency, and social language proficiency. The purpose of this mixed-methods study was to trial an English language exam specific to the nursing profession -- the Canadian English Language Benchmark Assessment for Nurses (CELBAN) -- in 13 nursing students and identify how language testing scores related to habits of literacy in reading, writing, speaking, and listening. In addition to writing the CELBAN exam students competed several questionnaires and participated in a one-on-one interview where they discussed their literacy habits and completed a series of literacy activities including C-tests and role plays. Findings indicated that the students' performance on the CELBAN and C-test was related. Integrated data collection showed that students with low reading and writing self-efficacies and poor reading habits tended to also have poorer performance on the CELBAN and C-tests. Presently, medical language literacy is a facet of nursing practice that is "better caught than taught." Overall, this study adds to the literature by demonstrating that students have reading, writing, speaking and listening habits that are amenable to intervention through attention to pedagogical practices such as simulated learning and formalized supports.