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. Bounding pulses are not typically associated with a hemolytic transfusion reaction. B. Low back pain is a classic early sign of a hemolytic transfusion reaction caused by the destruction of red blood cells and renal involvement. This symptom warrants immediate action. C. Distended jugular veins are more related to heart failure or fluid overload, not hemolytic transfusion reactions. D. Hypertension is not a common sign of hemolytic transfusion reactions; hypotension is more likely.