Background <p>In nursing education, telenursing presents many challenges that contribute to psychological distress among nursing students. Understanding these challenges is essential for improving learning outcomes and student well-being. This study aimed to examine factors contributing to psychological distress among nursing students engaged in telenursing, as well as the possible relationships between these factors.</p> Methods <p>This cross-sectional study was conducted with a purposive sample of 204 students. A structured questionnaire was distributed to collect data from the nursing students. Using SPSS (version 28), uni-, bi-, and multivariate analyses were performed to explore the relationships between variables.</p> Results <p>Most participants reported moderate knowledge (mean: 7.77, standard deviation [SD]: 1.95; range: 0–10), attitudes (mean: 37.15, SD: 6.70; range: 12–50), and psychological distress (mean: 14.09, SD: 3.99; range: 6–24) related to telenursing. Significant differences were found in access to computers and distress levels (<i>p</i> = 0.016). Attitude was negatively related to psychological distress (<i>r</i> = -0.207, <i>p</i> = 0.003) and positively associated with knowledge (<i>r</i> = 0.295, <i>p</i> &lt; 0.001). In the regression analysis, the models for knowledge, attitude, and psychological distress were significant (<i>p</i> &lt; 0.05).</p> Conclusions <p>This study highlights the need for educators to foster a learning environment that supports student success and well-being. Implementing technology training programs, encouraging positive attitudes toward telenursing, and developing strategies to reduce distress are recommended. Future interventional studies should focus on improving nursing education and practice while fostering a supportive environment.</p>