A nurse is monitoring a client who is receiving a transfusion of packed RBCs. The nurse should identify which of the following findings as an indication of a febrile nonhemolytic reaction?

D. Chills are a hallmark sign of febrile nonhemolytic reactions. These reactions typically present with fever, chills, and occasionally rigors (shivering). They are caused by recipient antibodies reacting to donor leukocytes or cytokines present in the transfused blood components. A. Dyspnea (difficulty breathing) is not typically associated with febrile nonhemolytic reactions. It is more commonly seen in acute hemolytic reactions or transfusion-related acute lung injury (TRALI). B. Urticaria (hives) is more commonly associated with allergic transfusion reactions rather than febrile nonhemolytic reactions. C. Vomiting is not a characteristic feature of febrile nonhemolytic reactions. It may occur in some cases of transfusion reactions, but it is not specific to febrile nonhemolytic reactions.