Nursing students have typically found the study of chemistry to be one of their major challenges in a nursing course. This mixed method study was designed to explore how prior experiences in chemistry might impact chemistry achievement during a health science unit. Nursing students (N = 101) studying chemistry as part of a health science unit were divided into three groups based on prior chemistry experience and into three groups based on their academic performance in the health science unit. Although there was no significant difference in the mean achievement scores for students who had completed a 3-day chemistry bridging course (BC) and students who had not studied chemistry since year 10 (PC), 52.3% of the PC group were low achievers compared to 33.3% of the BC group. The BC students were more evenly distributed across the academic performance categories than was the case for PC students. Students who had previously studied senior chemistry at high school level (SC) had a mean achievement score which was significantly greater than that obtained by BC and PC students. Students described their chemistry experiences in the context of academic performance using terms that related to: basic chemistry as a foundation for further study; the use of different representations in chemistry; and the language and logical structure of chemistry. There were differences and similarities in the way the different prior chemistry experience groups related to these issues. Low chemistry achievers became less optimistic about the relevance of chemistry to nursing as the course proceeded.