Nursing Fundamentals and Professional Ethics
What the exam tests
This domain checks whether you can apply the legal and ethical framework of nursing practice in Kazakhstan to everyday decisions: scope of practice, consent, confidentiality, professional boundaries, delegation, and reporting.
Core rules
- Practise within your licence and facility protocols; do not perform procedures reserved for physicians or specially trained nurses.
- Respect autonomy: obtain informed consent before care, explain risks and alternatives, and document refusal.
- Keep medical secrecy. Share information only with the care team on a need-to-know basis and through secure channels.
- Apply the four principles: beneficence, non-maleficence, justice, and respect for autonomy. Veracity and fidelity guide communication.
- Report errors and near misses through the internal safety system; concealment is a separate professional violation.
- Accept only clear, lawful orders. A verbal emergency order must be read back, documented, and countersigned according to policy.
Worked example
A competent adult with a gangrenous toe refuses amputation after a full explanation. The nurse does not pressure the patient or ask relatives to sign. She verifies understanding, documents the refusal and the patient’s questions, informs the physician, and continues wound care and pain relief. Reasoning: autonomy applies to competent adults; the nurse’s duty is to ensure informed refusal, not to override it. If the patient later becomes unconscious and the situation is an emergency, the team follows the previously expressed wishes and legal surrogate decision rules.
Traps
Calling a family request “consent” when the patient is competent; discussing a patient’s diagnosis in a shared room or on social media; following a verbal order with no read-back; and documenting opinions (“patient difficult”) instead of observable facts. Also remember that advocacy means helping the patient voice a choice, not making the choice for them.