Nurses need to be able to make drug calculations competently. In this study, involving 229 second year British nursing students, we explored the influence of mathematics anxiety, self-efficacy, and numerical ability on drug calculation ability and determined which factors would best predict this skill. Strong significant relationships (p < .001) existed between anxiety, self-efficacy, and ability. Students who failed the numerical and/or drug calculation ability tests were more anxious (p < .001) and less confident (p ≤ .002) in performing calculations than those who passed. Numerical ability made the strongest unique contribution in predicting drug calculation ability (beta = 0.50, p < .001) followed by drug calculation self-efficacy (beta = 0.16, p = .04). Early testing is recommended for basic numerical skills. Faculty are advised to refresh students' numerical skills before introducing drug calculations.
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