Sounds like a sticky topic to me....
Successful study tactics are highly individualized (IMHO). What works for one won't work for another. So, while I'm not a 4.0 student, here is how I have overall 92% average in Nursing and an overall 97% average in pharmacology after my 1st year without losing my mind or any sleep. (Note that at my school 100-94 = A, 93-87 = B, 86-80 = C and below 80 = gone.)
1) know what works for you. Nursing school
is different than high school, undergrad and grad work. It's all about understanding with some memorization thrown in. People who used strict memorization techniques in my class have not done well. People who understand "why" tend to do well. Experiment with different tactics until you find what works for you.
2) go to class. Instructors tend to let you know what they'll be emphasizing on tests. You also get additional detail on the powerpoint slides. This was key for my learning process.
3) read the associated material. Either before the lecture or after. Figure out what works best for you. I don't tend to study the texts, but rather read 'em like I would a novel, which means fairly quickly. Personally, I like to read the text before class.
4) review your notes the same day you took them. This reinforces what you heard and wrote. It also identifies areas that need clarification.
5) flash cards work for some topics but not others. I used flash cards for ABGs and other lab values. Now, I don't use traditional flash cards. What I do is put the info on one side in a table format. I carry them with me at all times and scan through them whenever I have a moment, i.e., sitting in traffic, standing on a checkout line, riding a chairlift, whenever.
6) have fun learning. This material is really cool and unlike most subjects we've been taught, we get to use it immediately.
7) study groups. We formed a small group that only met for the hour before each test. We simply bounced stuff off of each other in a free-association type of discussion and then walked in to take the test. It was amazing how many things we talked about showed up on the test. Interestingly, this group grew from 3 people at the beginning of the term to about 10 before our final last week. This is the only type of study group that works for me. YMMV.
Good luck and have fun with nursing school.