41. Choice B is the correct answer. The dry cough is coming from the elevated bradykinnin associated with ACE inhibitors. Lowering the dose usually does not take this side effect away and may not give you adequate blood pressure control. Switching the patient to diovan, the angiotensin receptor blocker, uses a very similar mechanism but does not elevated bradykinnin levels and will likely give you the same blood pressure control. The patients HR is too low to start metoprolol. Usually beta blockers are not start on patients with HR less than 60. Albuterol is not indicated because the patients clinical picture is not consistent with bronchospasm.
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