A nurse is providing education to a client who is scheduled for a left knee arthroplasty. Which of the following statements regarding informed consent indicates client understanding Of the teaching?

A. The surgeon must obtain informed consent before surgery and before the client enters the operating room. This statement reflects misunderstanding. B. Asking the nurse to explain surgical details indicates the client lacks sufficient information; informed consent requires full understanding from the provider performing the procedure. C. Expressing uncertainty suggests the client has not yet consented and needs further clarification before signing. D. This statement accurately reflects informed consent — the client voluntarily signs the form after receiving explanation of the procedure, risks, benefits, and alternatives, indicating understanding and permission.