If something which requires approval (such as a Nuwisha) has been played before it is approved, that is grounds for immediate denial of the approval.
A character with an item (say a merit, flaw, disicpline) that requires approval can enter play, but the item cannot be used or refered to. A character with a background item that requires approval can enter play, but no reference to the background that requires approval can be made. Ignoring that is grounds for immediate denial of the approval.