A nurse is caring for a client who understands a prescribed surgical procedure, but cannot read or write. Which of the following actions should the nurse take?

A. Contact the client's power of attorney to sign the consent is incorrect. A client who understands the procedure and is competent to consent does not require a surrogate or power of attorney. Using a surrogate unnecessarily may violate the client’s autonomy. B. Inform a family member of the need to sign the consent is incorrect. Family members are not required to sign if the client is competent to provide informed consent. Consent must be obtained directly from the client whenever possible. C. Notify the surgical team that the client is unable to sign the consent is incorrect. The surgical team does not need to intervene simply because the client cannot read or write, as alternative methods exist to document consent legally. D. Allow the client to sign the consent with an X is correct. If a client is illiterate but mentally competent, they can provide informed consent by making a mark, such as an X, on the consent form. The nurse should also ensure that a witness signs the form to verify that the client understood the procedure and voluntarily provided consent.