Advanced practice nursing roles are promoted internationally to improve access and quality in primary health care (PHC). In Brazil, nurses in PHC already perform autonomous clinical work, but the extent to which their consultations include activities aligned with advanced practice remains unclear.To analyze indicators of advanced clinical activities within nurses’ routine PHC consultations; to identify which activities are most and least frequent; and to inform implementation through a strategic guide.Descriptive exploratory quantitative study using secondary data from a multicenter database of recorded nursing consultations in three Basic Health Units (Unidades Básicas de Saúde, UBS) in Brazilian municipalities. Eighteen nurses were included. Seventy three consultations were analyzed using a structured instrument based on seven International Council of Nurses clinical activities for advanced practice. These activities were prescribing medicines, ordering tests, indicating treatments, making clinical diagnoses, holding responsibility for a patient panel, referring and counter referring, and being recognized as a first point of contact. Frequencies and proportions were calculated. Associations between consultation type and selected activities were tested with significance set at p<0.05.Most nurses were women (72.2%). Consultations were mainly in women’s health (75.3%), followed by older people’s health (12.3%). Activities related to first contact and responsibility for a patient panel were frequent, reflecting core nursing work in PHC. Activities requiring higher clinical complexity showed limited occurrence and varied by consultation type. There was a statistically significant association between consultation type and prescription being absent versus performed (p=0.0013). When restricted to women’s health consultations, this association was not significant (p=0.1798). Similar patterns were observed for ordering tests (p=0.0515) and documenting clinical diagnosis (p=0.7408).The findings suggest that Brazilian PHC nurses consistently deliver longitudinal, first contact care, but advanced clinical decision making tasks such as prescribing, test ordering, diagnosis documentation, and counter referral are not yet routine across consultation types. Local protocols, training, and governance may influence this variability.Indicators of advanced practice are present but uneven. Strengthening regulation, education, and service protocols may support safer expansion of advanced clinical activities beyond women’s health and increase equity in access to PHC services.