Answer to Question 1
D
The nonbenzodiazepine, benzodiazepine receptor agonists are newer medications that appear to have better safety profiles and fewer adverse effects than the benzodiazepines. They are also associated with a lower risk of abuse and dependence than the benzodiazepines, although abuse and dependence do occur. Examples of medications in this class include zolpidem (Ambien), zaleplon (Sonata), and eszopiclone (Lunesta). Benzodiazepines are a common classification of drug used to treat sleep problems when a change in sleep hygiene is not effective. Examples of benzodiazepines include temazepam (Restoril), flurazepam (Dalmane), estazolam (ProSom), and triazolam (Halcion). A new class of drugs called melatonin agonists promotes the onset of sleep by increasing levels of the natural hormone melatonin, which helps normalize circadian rhythm and sleep-wake cycles. Ramelteon (Rozerem) belongs to this drug class. There is no such classification as L-tryptophan antagonist. L-tryptophan is thought to promote sleep.
Answer to Question 2
C
Because sleep is a subjective experience, only the patient is able to report whether it is sufficient and restful. Patients are your best resource for describing a sleep problem and any change from their usual sleep and waking patterns. Number of hours of sleep, sleep-wake pattern, and number times awakes while sleeping are not the most important to assess to determine effectiveness of the patient's sleep, the subjective experience of the patient is the most important.
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