<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 25-year-old male presents to his primary care physician with a chief complaint of anxiety and fatigue. The patient states that during this past week he has had final exams and has been unable to properly study and prepare because he is so exhausted. He states that he has been going to bed early but has been unable to get a good nights sleep. The patient admits to occasional cocaine and marijuana use. Otherwise, the patient has no significant past medical history and is not taking any medications. On physical exam you note a tired and anxious appearing young man. His neurological exam is within normal limits. The patient states that he fears he will fail his courses if he does not come up with a solution. Which of the following is the best initial step in management?? A: Zolpidem, B: Alprazolam, C: Melatonin, D: Sleep hygiene education, E: Polysomnography,  <response>: This is a question about the initial management of a 25-year-old male patient presenting with anxiety and fatigue due to poor sleep during a stressful exam period. He has a history of occasional cocaine and marijuana use. The key points are:- Young patient with no significant medical history presenting with sleep issues and anxiety due to situational stressors exams- History of occasional illicit substance use - Unremarkable physical exam- Patient is seeking help with his sleep issues and anxiety impacting his ability to prepare for exams This suggests a situational cause of his symptoms rather than an underlying medical disorder. Therefore, the initial step should be conservative management without medications. Choices A and B Zolpidem and Alprazolam are medications that could be habit-forming and should be avoided as first-line treatment in this situation. Choice C melatonin is a supplement that could be reasonable but education on sleep hygiene would be a safer initial approach. Choice E polysomnography is premature given the lack of chronicity or red flags in this clinical scenario.D: Sleep hygiene education 