A nurse is assessing a client who is receiving a unit of packed RBCs. Which of the following findings indicates the client is having a hemolytic transfusion reaction?

A. Distended jugular veins: Distended jugular veins are more indicative of fluid overload which is a potential complication of rapid blood transfusion or right-sided heart failure, not a hemolytic transfusion reaction. B. Low back pain: Low back pain is a classic sign of a hemolytic transfusion reaction, which occurs when the immune system attacks the transfused red blood cells. This pain can be caused by the release of hemoglobin from lysed RBCs, which can accumulate in the kidneys and cause damage. C. Bounding pulses: Bounding pulses are typically associated with fluid overload or hyperdynamic circulation and are not a specific sign of a hemolytic transfusion reaction. D. Hypertension: Hypertension is not a specific or common sign of a hemolytic transfusion reaction. The reaction more typically involves fever, chills, pain, and changes in vital signs like tachycardia, rather than hypertension.