A patient presents with a 3-day history of productive cough, fever of 38.5°C, and shortness of breath. Which assessment finding would most suggest pneumonia requiring urgent medical referral?
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A
Mild rhinorrhea with clear discharge
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B
Oxygen saturation of 91% on room air
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C
Sore throat with no cervical lymphadenopathy
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D
Dry cough for less than 24 hours