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1. A patient with hypertension is prescribed lisinopril, an angiotensin-converting enzyme
(ACE) inhibitor. The nurse should monitor the patient for which of the following adverse
effects of this drug?
a) Hyperkalemia*
b) Hypoglycemia
c) Hypocalcemia
d) Hyponatremia
Rationale: ACE inhibitors can cause hyperkalemia by inhibiting the secretion of
aldosterone, which regulates potassium excretion. Hypoglycemia, hypocalcemia, and
hyponatremia are not common side effects of ACE inhibitors.
2. A patient with type 2 diabetes mellitus is prescribed metformin, a biguanide that lowers
blood glucose levels by decreasing hepatic glucose production and increasing insulin
sensitivity. The nurse should instruct the patient to avoid which of the following
substances while taking this drug?
a) Alcohol*
b) Caffeine
c) Grapefruit juice
d) Milk
Rationale: Alcohol can increase the risk of lactic acidosis, a rare but serious complication of
metformin therapy. Lactic acidosis is characterized by nausea, vomiting, abdominal pain,
hyperventilation, and hypothermia. Caffeine, grapefruit juice, and milk do not interact
significantly with metformin.
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