NCLEX · Pharmacological Therapies

A client is taking an ACE inhibitor (lisinopril) for hypertension. Which side effect should the nurse teach the client to report?

Correct answer

A persistent dry cough (and rarely, angioedema — swelling of the face, lips, tongue, or throat, which is a medical emergency)

  1. A Increased appetite
  2. B A persistent dry cough (and rarely, angioedema — swelling of the face, lips, tongue, or throat, which is a medical emergency)
  3. C Weight gain
  4. D Improved vision

Why this is the answer

ACE INHIBITOR SIDE EFFECTS (drugs ending in '-pril': lisinopril, enalapril, ramipril): DRY COUGH: Persistent, non-productive cough occurs in 5-20% of patients due to bradykinin accumulation; often requires switching to an ARB (angiotensin receptor blocker, '-sartan' drugs) which doesn't cause cough; ANGIOEDEMA: Rare but life-threatening — swelling of face, lips, tongue, throat; can obstruct the airway; MEDICAL EMERGENCY requiring immediate discontinuation and treatment; HYPERKALEMIA: ACE inhibitors raise potassium — monitor levels, caution with potassium supplements/salt substitutes; HYPOTENSION: Especially first-dose; FIRST-DOSE: monitor for orthostatic hypotension; RENAL: Monitor kidney function (can worsen in renal artery stenosis); TERATOGENIC: Contraindicated in pregnancy; PATIENT EDUCATION: Report persistent cough, any facial/throat swelling immediately, dizziness; rise slowly; avoid salt substitutes (potassium); LPN role: teach side effects, monitor BP and potassium, report cough and angioedema.
Source: NCLEX-PN Physiological — Pharmacology, ACE Inhibitor Side Effects