A client with heart failure is taking an angiotensin-converting enzyme inhibitor (ACE-I) and reports a nagging cough. Which replacement medication will the nurse expect to be prescribed for this client?

Choice A reason: Calcium channel blockers reduce blood pressure by relaxing vascular smooth muscle but are not primary replacements for ACE inhibitors in heart failure. They do not address the renin-angiotensin system or the cough side effect mechanism, making them less suitable for this scenario. Choice B reason: Beta blockers reduce heart rate and myocardial oxygen demand in heart failure but do not directly replace ACE inhibitor effects on the renin-angiotensin system. They are often used adjunctively, not as replacements, and do not address the cough side effect. Choice C reason: Potassium-sparing diuretics manage fluid retention in heart failure but do not inhibit the renin-angiotensin system like ACE inhibitors. They are not a direct replacement and do not address the cough, which is specific to ACE inhibitor intolerance. Choice D reason: ARBs block angiotensin II receptors, providing similar benefits to ACE inhibitors in heart failure by reducing vascular resistance and cardiac workload. They are less likely to cause cough, as they do not increase bradykinin levels, making them the expected replacement medication.