Test Questions

Pharmacotherapeutic Options for Chronic Insomnia

Exam Questions

1. Approximately _____ of adults in the U.S. are affected by symptoms of insomnia leading to social and occupational impairment.
    A. 1%
    B. 10%
    C. 30%
    D. 50%
2. Chronic insomnia is best defined as symptoms of insomnia recurring:
    A. Occasionally for more than one year
    B. Nightly for two weeks
    C. Most nights for at least one month
    D. Every month
3. The incidence of insomnia is greater in:
    A. Men
    B. Women
    C. Adolescents
    D. None of the above
4. Which of the following nonpharmacologic strategies induces mild sleep deprivation to enhance faster sleep onset and quality?
    A. Sleep restriction
    B. Cognitive therapy
    C. Stimulus control
    D. Biofeedback
5. Which of the following nonpharmacologic strategies is recommended to be included in every treatment plan for patients presenting with sleep disturbance symptoms?
    A. Sleep restriction
    B. Paradoxical intention
    C. Relaxation training
    D. Sleep hygiene education
6. Which of the following sleep hygiene techniques may improve the quality and quantity of sleep?
    A. Limiting heavy meals and liquids before bedtime
    B. Consuming an alcoholic beverage immediately before bedtime
    C. Incorporating naps into the daily routine
    D. Limiting exercise during the daily routine
7. Benzodiazepines decrease sleep latency and increase total sleep time due to their ability to enhance the activity of _____.
    A. Melatonin
    B. GABA
    C. Serotonin
    D. Histamine
8. Which of the following benzodiazepines is most likely to cause residual daytime sedation?
    A. Flurazepam
    B. Triazolam
    C. Temazepam
    D. Estazolam
9. Amnesia and memory loss have been reported most often with _____.
    A. Temazepam
    B. Triazolam
    C. Zolpidem
    D. Zaleplon
10. Which statement best describes the potential complications of taking long half-life benzodiazepines?
    A. Drowsiness the next day and prolonged effect after discontinuation
    B. Immediate onset and rapid elimination
    C. An absence of side effects
    D. Hyperstimulation the morning after
11. Which of the following hypnotic agents has the longest half-life?
    A. Eszopiclone
    B. Ramelteon
    C. Zaleplon
    D. Zolpidem
12. Which of the following is true regarding eszopiclone?
    A. It is the S-isomer of a clinically proven hypnotic agent available outside the U.S.
    B. Tolerance to its effects develops quickly
    C. The dose does not need to be reduced in the elderly
    D. It is a new short-acting benzodiazepine
13. Benefits seen with the use of eszopiclone include:
    A. No potential drug interactions
    B. Can be taken within four hours of wakening
    C. No tolerance has been observed
    D. No reported side effects
14. Which agent's mechanism of action involves selectively binding to receptors of an endogenous hormone?
    A. Quazepam
    B. Diphenhydramine
    C. Valerian
    D. Ramelteon
15. Which of the following is true regarding ramelteon?
    A. Ramelteon requires dosage reduction in the elderly
    B. Ramelteon should be taken with a high-fat meal
    C. The recommended dosage is 8 mg, 30 minutes before bedtime
    D. Middle-of-the-night dosing is recommended for ramelteon
16. Trazodone should be used with caution in patients with:
    A. Depression
    B. Cardiovascular disease
    C. Sleep-onset insomnia
    D. Hypothyroidism
17. Which of the following statements is false in regard to OTC and herbal products used to treat insomnia?
    A. Homeopathic preparations with ingredients such as valerian, hops, and melatonin are used for insomnia
    B. OTC antihistamines alone or combined with analgesics may have sedating effects, but they also may have undesirable anticholinergic effects that influence the risk-benefit ratio
    C. Products designated “generally regarded as safe” (GRAS) are completely devoid of adverse effects
    D. Second-generation antihistamine agents are not effective as sleep agents due to limited ability to cross the blood-brain barrier
18. The most significant disadvantage of sedating antihistamines used for insomnia is:
    A. Cholinergic effects
    B. Tolerance development after a few doses
    C. High risk of abuse potential
    D. Rebound insomnia upon discontinuation
19. _____ is considered unsafe due to reports of hepatotoxicity.
    A. Valerian
    B. Kava
    C. Melatonin
    D. 5-HTP
20. Which of the following is the most accurate statement regarding melatonin?
    A. It has recently been approved by the FDA for treatment of insomnia
    B. Its effect on the sleep cycle has been formally studied in children
    C. Studies clearly demonstrate the value of melatonin in the management of all types of insomnia
    D. The magnitude of beneficial effects following melatonin administration to insomniacs is unclear

Evaluation Questions

21. Met objective 1:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
22. Met objective 2:*
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
23. Met objective 3:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
    F. N/A for Pharmacy Technicians
24. Met objective 4:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
    F. N/A for Pharmacy Technicians
25. Related to your practice needs:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
26. Will help you improve patient care:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
27. Avoided commercial bias:
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
28. How would you rate the overall quality of the material presented?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
29. How would you rate the overall user friendliness of the program?
    A. Excellent
    B. Very Good
    C. Good
    D. Fair
    E. Poor
30. Comments on this program:
 
* Also applies to pharmacy technicians