Under What Circumstances Would Result in a Nurse Not Securing

Under what circumstances would result in a nurse not securing a signed informed consent from a client scheduled for a bilateral inguinal hernia repair?

A) The client voluntarily came to the surgery center and suggested the need for a hernia repair.
B) The client completely understands the necessity of the procedure, but is nervous and unhappy about going through with the surgery.
C) The client has been diagnosed with early-onset dementia.
D) The client is a month away from his 18th birthday.