The challenges facing advanced practice registered nurses (APRNs) are multifaceted and propelled by a rapidly changing health care delivery system. These changes include more opportunities to expand the scope of nursing practice while at the same time increasing accountability and responsibility of the APRN. This chapter focuses on the practice areas of the APRN and the pivotal roles APRNs play in the delivery of health care. Educational, licensure, and certification requirements are addressed, along with regulatory and scope of practice issues. Health reform and increased autonomy are reviewed, as well as the exposure to malpractice claims. APRNs are nurses “educated at the master’s or post-master’s level and in a specific role and patient population. APRNs are prepared by education and certification to assess, diagnose, and manage patient problems, order tests and prescribes medications” (National Council of State Boards of Nursing [NCSBN], 2016).