A client who has been on a mechanical ventilator for three days develops a fever of 101.0°F, green sputum, and right lower lobe crackles. The nurse contacts the health care provider regarding possible development of which complication?

A. Pneumothorax usually presents with sudden chest pain and respiratory distress, not fever or sputum changes. B. Stress ulcers cause gastrointestinal bleeding, not respiratory symptoms. C. Pulmonary embolism presents with sudden dyspnea, chest pain, but not usually fever or purulent sputum. D. Ventilator-associated pneumonia is common after several days on a ventilator and is indicated by fever, purulent sputum, and localized lung findings such as crackles.