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With the increasing number of foreign nursing students enrolled in university nursing programmes in the United States and the paucity of relevant studies it would seem essential to assess the difficulties foreign nursing students encounter in their adjustment to university nursing programmes and to evaluate the mechanisms that facilitate their adaptation. Data from this study was based on the results of 82 questionnaires completed by foreign nursing students enrolled in university nursing programmes nationwide. Language difficulties, a faculty to a great extent unfamiliar with foreign cultures, rapid pace, insufficient clinical experience, and highly competitive programmes were found to cause the foreign nursing students problems in their educational experiences. In addition to identifying the difficulties foreign nursing students have in adjusting to a university nursing programme, this paper proposes and discusses changes that would help make the foreign nursing students’ experiences more meaningful and effective.