Effective nursing care can be threatened when nurses are not culturally attuned with their patients. Associate degree nursing (ADN) students receive information about diverse ethnicities in the nursing curriculum, but it may not be sufficient to provide the expertise necessary to care for patients of various cultural backgrounds. The purpose of this quantitative study was to explore the 2nd year ADN students' levels of cultural competence and their perceptions of self-efficacy in working with Caucasian, African American, Native American, Hispanic, and Asian ethnicities. The study used a cross-sectional survey design to determine if a relationship existed between the students' reported cultural competencies and their self-efficacy scores while providing care to patients of these diverse cultures. The process of cultural competence in the delivery of health care services was used as the theoretical framework for this study. A volunteer convenience sample of 64 2nd-year ADN students completed the Nurse Cultural Competence Scale and the Cultural Self-Efficacy Scale. The Pearson-Product Moment correlation revealed a significant negative, moderate relationship between self-efficacy and the students' perceptions of cultural competence. A project was designed to enhance skills and knowledge to improve the students' cultural competency while caring for patients of Asian, Native American, and Hispanic cultures because minimal familiarity of those cultures contributed most to the negative correlation. Research on methods to improve cultural competence among health care professionals should be continued. Positive social change will occur as nursing students gain proficiency in their abilities to provide culturally appropriate care to patients of diverse ethnic backgrounds.