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.