# A client treated for lip and tongue swelling that started after beginning lisinopril is now stable and ready for discharge teaching. Which instruction should the nurse give about the medication?

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> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522680&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client treated for lip and tongue swelling that started after beginning lisinopril is now stable and ready for discharge teaching. Which instruction should the nurse give about the medication?

## Option

1. Stop the lisinopril for good and discuss another drug class with the provider **✔ Correct answer**
2. Resume the lisinopril at a lower dose and report any return of the swelling
3. Start an angiotensin receptor blocker tonight in place of the lisinopril dose
4. Take an antihistamine before each lisinopril dose to prevent further swelling

**Correct answer: 1**

## Explanation

Angioedema from an ACE inhibitor can recur more severely and is a reason to discontinue the class. The replacement drug is chosen by the provider rather than started by the client.

## In-depth explanation

Quick answer
The drug is stopped for good, and the provider selects the replacement.

Why this is correct
Angioedema is a bradykinin-mediated class effect rather than a dose-related one, so a smaller dose carries the same risk. A recurrence can involve the airway, which makes rechallenge unsafe.

Easy analogy or mental picture
It is an allergy-style exit from the whole class, not a speed adjustment. The comparison conveys permanence while leaving the substitute choice to the prescriber.

Memory hook
ACE inhibitor angioedema ends the class, not just the dose.

NCLEX decision rule
After ACE inhibitor angioedema, the drug is discontinued and not rechallenged. Any substitute, including an angiotensin receptor blocker, is a prescribing decision made with the provider.

Why the other choices are wrong
Dose reduction, self-starting a substitute, and premedication all keep the client exposed to a reaction that can involve the airway.References

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]MedlinePlus: LisinoprilU.S. National Library of Medicine

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