This study evaluated a program to identify and support students at risk for failure in nursing courses or NCLEX-RN. A case management model (CMM) was implemented to provide assessment of and support for 183 bachelor of science in nursing students; 83 were identified as at risk by the CMM criteria. The CMM involved student self-evaluation and grade assessment of prerequisite and nursing courses. Science course grades were all found to be significantly higher for those students who passed NCLEX-RN on the first attempt than those who did not. Admission GPA was significant (t = 2.443, P = .018). Using a Motivated Strategies for Learning Questionnaire for self-evaluation, at-risk students rated their performance in nursing courses higher in every area than the non-at-risk student group, significantly higher for self-efficacy (t = 2.829, P = .005) and metacognition (t = 2.426, P = .016). Neither task value nor critical thinking scores were significant. Graduation rate was 100% with 158 students passing NCLEX-RN on the first attempt (64 of 83 at risk and 94 of 100 non-at risk). The CMM was effective in identification and support of at-risk students.