Lisinopril MCQs With Answer

Lisinopril MCQs With Answer provides B.Pharm students a focused, keyword-rich overview of lisinopril pharmacology, mechanism, pharmacokinetics, indications, adverse effects, contraindications and drug interactions. These lisinopril MCQs cover ACE inhibitor action, renal elimination, bradykinin-mediated cough and angioedema, hyperkalemia risk, monitoring parameters, dose adjustments in renal impairment and pregnancy warnings. The questions are designed to deepen understanding of clinical use, lab monitoring and patient counseling points relevant to pharmaceutical practice. This set emphasizes applied knowledge needed for therapeutics, dispensing and clinical pharmacy. Now let’s test your knowledge with 30 MCQs on this topic.

Q1. What is the primary mechanism of action of lisinopril?

• Blocks beta-adrenergic receptors in the heart
• Inhibits angiotensin-converting enzyme, reducing angiotensin II formation
• Stimulates angiotensin II receptors to increase vasoconstriction
• Inhibits renin release from the kidney

Correct Answer: Inhibits angiotensin-converting enzyme, reducing angiotensin II formation

Q2. Which statement about lisinopril’s metabolic status is correct?

• Lisinopril is a prodrug that requires hepatic activation
• Lisinopril is extensively metabolized by CYP3A4
• Lisinopril is pharmacologically active and not a prodrug
• Lisinopril is converted to enalaprilat in vivo

Correct Answer: Lisinopril is pharmacologically active and not a prodrug

Q3. How is lisinopril primarily eliminated from the body?

• Hepatic metabolism and biliary excretion
• Renal excretion of unchanged drug
• Metabolism by intestinal flora
• Exhalation via the lungs

Correct Answer: Renal excretion of unchanged drug

Q4. Which adverse effect is most commonly associated with lisinopril and other ACE inhibitors?

• Bronchospasm due to beta-agonist activity
• Persistent dry cough due to bradykinin accumulation
• Severe hyperglycemia
• Ototoxicity with high-pitched tinnitus

Correct Answer: Persistent dry cough due to bradykinin accumulation

Q5. Which serious, potentially life-threatening adverse reaction can occur with lisinopril?

• Stevens-Johnson syndrome
• Angioedema with facial or laryngeal swelling
• Aplastic anemia
• Acute pancreatitis

Correct Answer: Angioedema with facial or laryngeal swelling

Q6. What is the recommendation regarding lisinopril use during pregnancy?

• Safe during all trimesters with no monitoring
• Use only in the first trimester under supervision
• Contraindicated due to risk of fetal renal damage and death
• Preferred antihypertensive for pregnant patients

Correct Answer: Contraindicated due to risk of fetal renal damage and death

Q7. Which drug interaction is important between lisinopril and NSAIDs?

• NSAIDs potentiate lisinopril’s antihypertensive effect, causing severe hypotension
• NSAIDs reduce antihypertensive effect and increase risk of renal impairment
• NSAIDs increase lisinopril metabolism via CYP induction
• No clinically relevant interaction exists

Correct Answer: NSAIDs reduce antihypertensive effect and increase risk of renal impairment

Q8. Concurrent use of lisinopril with potassium supplements or potassium-sparing diuretics most likely causes:

• Hypokalemia due to increased aldosterone
• No change in potassium homeostasis
• Hyperkalemia due to reduced aldosterone-mediated excretion
• Increased sodium retention leading to edema

Correct Answer: Hyperkalemia due to reduced aldosterone-mediated excretion

Q9. How does lisinopril benefit patients with diabetic nephropathy?

• Increases glomerular filtration pressure to clear proteins
• Reduces intraglomerular pressure, decreasing proteinuria and slowing progression
• Acts as an osmotic diuretic to reduce renal workload
• Directly stimulates insulin secretion to control glucose

Correct Answer: Reduces intraglomerular pressure, decreasing proteinuria and slowing progression

Q10. What laboratory change is commonly monitored and may increase with lisinopril therapy?

• Decreased serum creatinine with long-term use
• Increased serum potassium and possible rise in serum creatinine
• Marked hypocalcemia
• Severe anemia due to hemolysis

Correct Answer: Increased serum potassium and possible rise in serum creatinine

Q11. Which parameters should be routinely monitored after initiating lisinopril?

• Liver enzymes and prothrombin time only
• Blood pressure, serum creatinine and serum potassium
• Thyroid function tests
• Serum magnesium and vitamin D levels

Correct Answer: Blood pressure, serum creatinine and serum potassium

Q12. In which renal vascular condition is lisinopril use particularly risky?

• Unilateral renal cyst
• Bilateral renal artery stenosis or stenosis in a solitary kidney
• Simple urinary tract infection
• Nephrolithiasis with stones

Correct Answer: Bilateral renal artery stenosis or stenosis in a solitary kidney

Q13. What is the recommended dosing strategy for initiating lisinopril in elderly or volume-depleted patients?

• Start at the usual adult maintenance dose immediately
• Start at a lower dose and titrate slowly to avoid hypotension
• Administer only intravenous lisinopril in the elderly
• Begin with potassium supplements to prevent hyperkalemia

Correct Answer: Start at a lower dose and titrate slowly to avoid hypotension

Q14. What is the approximate oral bioavailability of lisinopril?

• Nearly 100% bioavailable after oral dosing
• Approximately 25% oral bioavailability
• Less than 1% due to first-pass metabolism
• Bioavailability is unpredictable and varies by 90%

Correct Answer: Approximately 25% oral bioavailability

Q15. When are peak plasma concentrations of lisinopril typically observed after oral dosing?

• Within 15–30 minutes after dosing
• Around 6–8 hours after oral administration
• After 48–72 hours due to slow release
• Only after multiple weeks of therapy

Correct Answer: Around 6–8 hours after oral administration

Q16. What is the approximate elimination half-life of lisinopril in patients with normal renal function?

• Less than 30 minutes
• Approximately 12 hours
• Greater than 7 days
• No measurable half-life because it accumulates indefinitely

Correct Answer: Approximately 12 hours

Q17. ACE inhibition increases levels of which peptide, contributing to cough and angioedema?

• Endothelin
• Bradykinin
• B-type natriuretic peptide
• Substance P exclusively

Correct Answer: Bradykinin

Q18. How does lisinopril affect aldosterone secretion?

• Increases aldosterone secretion via AT2 receptor activation
• Decreases aldosterone secretion by lowering angiotensin II levels
• Has no effect on aldosterone
• Stimulates adrenal cortex to produce cortisol instead

Correct Answer: Decreases aldosterone secretion by lowering angiotensin II levels

Q19. Which distinction is correct between lisinopril and enalapril?

• Both are prodrugs that require hepatic activation
• Lisinopril is active as given; enalapril is a prodrug converted to enalaprilat
• Enalapril is not an ACE inhibitor while lisinopril is
• Lisinopril is administered intravenously only, enalapril orally

Correct Answer: Lisinopril is active as given; enalapril is a prodrug converted to enalaprilat

Q20. Which statement best describes acute overdose management for lisinopril?

• Gastric lavage is the only useful treatment
• Supportive care with IV fluids and vasopressors; lisinopril is dialyzable in severe cases
• Administer intravenous beta-blockers to counteract effects
• Immediate liver transplantation is required

Correct Answer: Supportive care with IV fluids and vasopressors; lisinopril is dialyzable in severe cases

Q21. Accumulation of which mediator primarily explains the ACE inhibitor-induced cough?

• Renin
• Bradykinin and substance P
• Angiotensin II
• Aldosterone

Correct Answer: Bradykinin and substance P

Q22. Combining lisinopril with a thiazide diuretic commonly results in:

• Pharmacologic antagonism and loss of antihypertensive effect
• Additive antihypertensive effect and possible enhanced renal protection
• Increased risk of myopathy due to interaction
• No clinical benefit over lisinopril alone

Correct Answer: Additive antihypertensive effect and possible enhanced renal protection

Q23. Shortly after starting lisinopril, a modest rise in which value is expected and often acceptable?

• Serum sodium by more than 50 mEq/L
• Serum creatinine due to decreased glomerular filtration pressure
• Serum albumin to supraphysiologic levels
• Platelet count with a dramatic increase

Correct Answer: Serum creatinine due to decreased glomerular filtration pressure

Q24. Major clinical indications for lisinopril include:

• Hypertension, heart failure, post-myocardial infarction and diabetic nephropathy
• Acute bacterial infections and fungal endocarditis
• Primary treatment for acute asthma exacerbations
• Management of chronic neuropathic pain as first-line

Correct Answer: Hypertension, heart failure, post-myocardial infarction and diabetic nephropathy

Q25. What is the guidance regarding breastfeeding while taking lisinopril?

• Lisinopril is recommended and increases milk production
• Avoid breastfeeding or consider alternative antihypertensive; use caution
• Breastfeeding is mandatory while on lisinopril therapy
• Lisinopril has no transfer into breast milk and is safe without restrictions

Correct Answer: Avoid breastfeeding or consider alternative antihypertensive; use caution

Q26. Lisinopril reduces stimulation of which receptor type downstream of angiotensin II?

• Beta-2 adrenergic receptors
• AT1 (angiotensin II type 1) receptors
• Muscarinic M3 receptors
• Vasopressin V2 receptors

Correct Answer: AT1 (angiotensin II type 1) receptors

Q27. In what formulation is lisinopril commercially available for outpatient use?

• Intravenous injection only
• Oral tablets for once-daily dosing
• Topical cream for transdermal absorption
• Nasal spray for acute hypertensive crises

Correct Answer: Oral tablets for once-daily dosing

Q28. Which combined physiologic effects explain lisinopril’s blood pressure lowering action?

• Increased heart rate and sodium retention
• Vasodilation and reduced aldosterone-mediated sodium retention
• Direct stimulation of vascular alpha receptors
• Inhibition of insulin release causing vasodilation

Correct Answer: Vasodilation and reduced aldosterone-mediated sodium retention

Q29. To which drug class does lisinopril belong?

• Calcium channel blockers
• Angiotensin-converting enzyme (ACE) inhibitors
• Loop diuretics
• Beta-adrenergic agonists

Correct Answer: Angiotensin-converting enzyme (ACE) inhibitors

Q30. Key patient counseling points for someone starting lisinopril include:

• Avoid potassium supplements and NSAIDs; report persistent cough or facial swelling
• Double the dose if one dose is missed and stop therapy if any nausea occurs
• Take with grapefruit juice to increase absorption and efficacy
• No monitoring is required and no interaction concerns exist

Correct Answer: Avoid potassium supplements and NSAIDs; report persistent cough or facial swelling

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