nurse practitioner prescriptive authority is regulated by the state board of nursing for each state the benefits to the patient of having an advanced practice registered nurse (APRN) prescriber include nurses care for the patient from a holistic approach and include the patient in decision making regarding their care clinical judgment in prescribing includes factoring in the cost to the patient of the medication prescribed criteria for choosing an effective drug for a disorder include consulting nationally recognized guidelines for disease management nurse practitioner practice may thrive under health-care reform because of the demonstrated ability of nurse practitioners to control costs and improve patient outcomes cultural factors that must be taken into account when prescribing include all of the above ethnic differences have been found in drug hepatic metabolism the national standards of culturally and linguistically appropriate services are required to be implemented in all organizations that receive federal funds according to the national standards of culturally and linguistically appropriate services, an interpreter for health care must be a professionally trained medical interpreter according to the U.S. office of minority health, poor health outcomes among African Americans are attributed to discrimination, cultural barriers, and lack of access to health care the racial differences in drug pharmacokinetics seen I American Indian or Alaskan Natives are largely unknown due to lack of studies of this population pharmacokinetics among Asians are universal to all the Asian ethnic groups False alterations in drug metabolism among Asians may lead to slower metabolism of antidepressants, requiring lower doses Asians from Eastern Asia are known to be fast acetylization. Fast acetylators require higher doses of drugs metabolized b acetylization to achieve efficacy