As the U.S. population ages and policy changes emerge, such as the Patient Protection and Affordable Care Act of 2010, the U.S. will experience a significant shortage of Registered Nurses (RNs). Many colleges and universities are attempting to increase the size of nursing cohorts to respond to this imminent shortage. Notwithstanding a 2.6% enrollment increase in 2013, there are still an inadequate number of qualified applicants being accepted to respond to the projected demand for 3.24 million Registered Nurses by 2022, a labor increase of 19% (AACN, 2014). It is important that nursing schools be able to forecast, with confidence, the probability that a student will successfully complete a nursing program and ultimately pass the National Council Licensure Examination-Registered Nurse (NCLEX-RN). Nursing programs use a variety of factors to determine which students are best prepared for these programs. Some of those factors are scholastic aptitude measures such as GPA and nursing aptitude measures (Byrd, et al., 1999, p.37) and standardized aptitude tests (Newton, Smith & Moore, 2007). Other research has shown that grades in particular courses are predictive of successful completion of nursing programs (Simon & Augustus, 2009; Uyehara et al., 2007; Herrera, 2013). The purpose of this study was to further examine the extent to which grades in gateway courses, particularly Human Pathophysiology, predict future success in completing a nursing program. The researchers found that the grade earned in Human Pathophysiology and the institution where it was taken were predictive of success in Adult Health.