Getting undergraduate Bachelor of Nursing students to understand and to apply procedures accurately for calculating medication doses in the clinical setting has always been an educational challenge for nursing academics. The experience at Central Queensland University (CQU) appears to reflect that of other universities both in Australia and overseas. In the past, lecturers have reported that students experience difficulties with medication mathematics undertaken in the second and third year of the three year program. Medication calculations require students to have a command of knowledge associated with arithmetic, ratios, fractions, percentages and conversion of units. Students who failed to achieve competence were advised to seek assistance from remedial services such as the Mathematics Learning Centre at CQU. Prerequisites for entry into the program do not include any senior secondary level mathematics. In August 2003, 120 students enrolled in the first year of the Bachelor of Nursing program were invited to complete a mathematics screening test. The test included 25 multiple choice questions. Sections included arithmetic, percentages, fractions, ratios and units. Results showed an average overall score of 15.83/25 (63.32%). The greatest area of weakness was in fractions. Although the findings of this study suggest a level of deficiency in basic mathematics skills in first year undergraduate nursing students, they do not support the introduction of a mathematical prerequisite. Analysis of the findings did not demonstrate any significant correlation between scores and the mathematical entry level of students. The literature suggests a number of strategies that could be incorporated into the undergraduate curriculum; however, further research into the effectiveness of these strategies needs to be undertaken before full-scale adoption is warranted.