A 46-year-old woman with hypertension and diabetes mellitus type II comes to the physician because of elevated blood pressure despite diet and exercise. She takes metformin to control her diabetes, Her temperature is 37°C (98.6°F), blood pressure is 146/72 mmHg, a pulse is 76/mm, respirations are 16/mu, and oxygen saturation is 98% on room air Which of the following medications is most likely to be prescribed?

**Core Concept**
The management of hypertension in a patient with diabetes mellitus type II involves the use of medications that can help control blood pressure and protect against the progression of diabetic nephropathy. This requires a combination of antihypertensive agents that can reduce blood pressure and slow the progression of renal disease.

**Why the Correct Answer is Right**
The patient's elevated blood pressure and diabetes mellitus type II make her a candidate for the use of an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB). These medications can reduce blood pressure and slow the progression of renal disease by reducing intraglomerular pressure and decreasing proteinuria. The use of an ACE inhibitor or ARB is particularly beneficial in patients with diabetes mellitus, as it can help to protect against the progression of diabetic nephropathy. Lisinopril is an example of an ACE inhibitor that can be used to treat hypertension in patients with diabetes mellitus type II.

**Why Each Wrong Option is Incorrect**
**Option A:** This option is not relevant to the management of hypertension in a patient with diabetes mellitus type II.
**Option B:** This option is not a first-line treatment for hypertension in patients with diabetes mellitus type II.
**Option C:** This option is not typically used as a first-line treatment for hypertension in patients with diabetes mellitus type II.

**Clinical Pearl / High-Yield Fact**
ACE inhibitors and ARBs are particularly beneficial in patients with diabetes mellitus type II as they can help to protect against the progression of diabetic nephropathy and reduce the risk of cardiovascular disease.

**Correct Answer:** C. Lisinopril is a commonly used ACE inhibitor in the management of hypertension in patients with diabetes mellitus type II.

✓ Correct Answer: C. Lisinopril