comparison of at least two APRN board of nursing regulations in your state/region with those of at least one other state/region. Describe how they may differ. Be specific and provide examples. Then, explain how the regulations you selected may apply to Advanced Practice Registered Nurses (APRNs) who have legal authority to practice within the full scope of their education and experience. Provide at least one example of how APRNs may adhere to the two regulations you selected..  From Tennessee

Title: A Comparative Analysis of APRN Board of Nursing Regulations in Tennessee and California


Advanced Practice Registered Nurses (APRNs) play an integral role in modern healthcare delivery, providing high-level care and services across various practice settings. The regulations governing APRNs differ among states, with variations in scope of practice, prescriptive authority, and regulatory oversight. This paper aims to compare and contrast the APRN board of nursing regulations in Tennessee and California, highlighting key differences and providing examples of their application in the context of APRN practice.

Tennessee APRN Board of Nursing Regulations:

In Tennessee, the Board of Nursing governs APRN practice through specific regulations that define and regulate the roles and responsibilities of APRNs within the state. The regulations in Tennessee stipulate that APRNs must have collaborative practice agreements (CPAs) with physicians or dentists to autonomously provide healthcare services. These CPAs outline the scope of practice for the APRN, including the authority to prescribe medications, and are reviewed and renewed every two years (Tennessee Board of Nursing, 2021).

Furthermore, Tennessee requires APRNs to obtain a Certificate of Fitness, which serves as evidence that the APRN possesses the necessary knowledge, skills, and abilities to practice safely within their scope. This certificate is issued by the Board of Nursing upon successful completion of educational and examination requirements (Tennessee Board of Nursing, 2021).

California APRN Board of Nursing Regulations:

In contrast, California has a different set of regulations governing APRNs. The California Board of Registered Nursing (BRN) authorizes APRNs to practice within their full scope of education and experience without the need for collaborative practice agreements. In California, patients’ needs and healthcare services determine the scope of practice for APRNs, rather than practice agreements with physicians (California Board of Registered Nursing, 2021).

California’s regulations allow APRNs to independently prescribe medications within their scope of practice after meeting specific educational and certification requirements. These requirements include completion of an advanced pharmacology course and the appropriate certification from a nationally recognized certifying body (California Board of Registered Nursing, 2021).

Key Differences:

One significant difference in APRN board of nursing regulations between Tennessee and California is the requirement of collaborative practice agreements in Tennessee. The collaborative practice agreements in Tennessee focus on the relationship between the APRN and a collaborating physician, which can limit the independence and autonomy of APRNs in providing care. In contrast, California does not require APRNs to enter into such agreements, allowing for more independent practice.

Another difference between the two states is the approach to prescribing authority. In Tennessee, APRNs must have a collaborative practice agreement with a physician or dentist to possess prescriptive authority. In California, however, APRNs can prescribe medications independently based on their scope of practice and additional education and certification requirements.

Application of Regulations to APRN Practice:

The regulations described above directly impact the practice of APRNs in both states. For example, in Tennessee, an APRN practicing in a primary care setting would need to establish a collaborative practice agreement with a physician to provide care and prescribe medications to their patients. The terms of the agreement would outline the specific responsibilities and limitations of the APRN within the practice setting.

On the other hand, a similar APRN in California would not require a collaborative practice agreement and could practice independently, providing care and prescribing medications within their scope of practice without physician involvement. This autonomy allows APRNs in California to respond more effectively to the needs of their patients, particularly in areas with limited access to physician services.


In conclusion, APRN board of nursing regulations vary significantly between Tennessee and California. Tennessee requires collaborative practice agreements and a Certificate of Fitness for APRNs, while California emphasizes independent practice and granting prescriptive authority based on education and certification. These regulations impact the autonomy and scope of practice for APRNs, and understanding these nuances is essential for ensuring safe and effective healthcare delivery.