A nurse is monitoring a client who is receiving a blood transfusion. The nurse identifies that the client has urticaria and is wheezing. Which of the following types of transfusion reactions should the nurse suspect?

The correct answer is D: Anaphylactic. Urticaria and wheezing are classic signs of an anaphylactic transfusion reaction. Anaphylaxis is a severe allergic reaction that can occur during a blood transfusion due to allergens in the donor blood. This reaction can lead to life-threatening symptoms like difficulty breathing, hives, and wheezing. Febrile transfusion reactions (choice A) typically present with fever, chills, and rigors but not urticaria or wheezing. Circulatory overload (choice B) is characterized by fluid overload symptoms like dyspnea, hypertension, and tachycardia. Acute hemolytic reactions (choice C) involve rapid destruction of donor red blood cells by recipient antibodies, leading to symptoms like fever, flank pain, and hemoglobinuria.