The role of the acute care nurse practitioner is being implemented in acute and tertiary care settings. As the role evolves, questions arise. Some of these questions relate to: 1) whether a need for the role has been clearly established; 2) whether the scope of acute care nurse practitioner practice has been identified distinctly; 3) the adequacy of educational preparation; 4) certification versus licensure; and 5) the nature of the relation between this role and other forms of advanced practice nursing. In this article, the authors identify and discuss some of these questions, provide information regarding current status, and postulate further potential resolutions.