As each state independently determines the APRN's scope of practice, vaguely worded SPAs that describe the APRN's scope of practice, e.g. of advanced nursing practice can undermine the plan of action for the future. practices. Interpreters can manipulate descriptions of what constitutes these acts. It may be construed strictly as providing nursing services and, therefore, will not provide a strong legal basis for arguments that APRNs should receive full fees for providing medical services. It is apparently difficult to argue to state legislators and policymakers that acts of advanced nursing practice parallel acts performed by a physician.