NURS 6630 WEEK 5 ASSIGNMENT 2026/2027 | Assessing &
Treating Bipolar Disorder | Korean Descent Woman
Post-Mania Hospitalization | 25 Clinical Questions | Pass
Guaranteed - A+ Graded
Part One: Diagnosis, Differential & Cultural Formulation (Korean Descent,
Post-Hospitalization) (Questions 1–9)
Q1: Ms. Park, a 26-year-old woman of Korean descent, presents for her first outpatient
appointment following a 21-day psychiatric hospitalization. During hospitalization, she
was described as having elevated mood, grandiose beliefs about her musical talent,
decreased need for sleep (sleeping 2–3 hours nightly for 10 days), pressured speech,
flight of ideas, and excessive spending on musical equipment she could not afford. She
denied hallucinations or delusions. Her symptoms caused significant impairment and
required hospitalization. Based on DSM-5 criteria, which diagnosis is most appropriate?
A. Bipolar II disorder, current episode hypomanic
B. Cyclothymic disorder
C. Bipolar I disorder, current episode manic
D. Borderline personality disorder
C. Bipolar I disorder, current episode manic [CORRECT]
D. Borderline personality disorder
Correct Answer: C
Rationale: A manic episode lasting at least 7 days (or any duration if hospitalization is
required) with marked functional impairment defines Bipolar I. Bipolar II (A) requires
hypomania, not full mania, and a major depressive episode. Cyclothymia (B) involves
subthreshold symptoms without full manic episodes. Borderline PD (D) features mood
reactivity lasting hours, not the sustained week-plus mania seen here.
,Q2: During the intake interview, Ms. Park reports that prior to her manic episode, she
experienced a 2-week period of profound sadness, anhedonia, fatigue, hypersomnia,
and feelings of worthlessness. These symptoms resolved approximately 3 weeks
before the manic episode began. Which statement best describes the diagnostic
implication of this history?
A. The prior depressive episode rules out bipolar disorder and suggests major
depressive disorder
B. The depressive episode supports a diagnosis of bipolar I disorder, as major
depressive episodes commonly occur in bipolar I
C. The depressive episode is irrelevant to the diagnosis since only manic symptoms
matter for bipolar I
D. The depressive episode indicates schizoaffective disorder rather than bipolar
disorder
B. The depressive episode supports a diagnosis of bipolar I disorder, as major
depressive episodes commonly occur in bipolar I [CORRECT]
D. The depressive episode indicates schizoaffective disorder rather than bipolar
disorder
Correct Answer: B
Rationale: Major depressive episodes are common in bipolar I and support rather than
contradict the diagnosis. They do not rule out bipolar disorder (A) or indicate
schizoaffective disorder (D) without psychotic features persisting outside mood
episodes. Depressive episodes are clinically relevant (C is wrong).
Q3: Ms. Park's mother attends the appointment and expresses concern that her
daughter's behavior during the manic episode was "shameful" and "embarrassing to the
family." She asks if this could be "hwa-byung," a condition she has heard about in the
Korean community. Which response by the PMHNP best demonstrates cultural
competence?
A. "Hwa-byung is not a real diagnosis, so we should focus on bipolar disorder."
, B. "Hwa-byung is a culture-bound syndrome related to suppressed anger in Korean
culture, but Ms. Park's symptoms of grandiosity, decreased sleep, and pressured speech
are more consistent with a manic episode of bipolar I disorder. We can address both the
biological illness and your family's cultural concerns."
C. "Your daughter definitely has hwa-byung, not bipolar disorder."
D. "Korean cultural concepts are not relevant to psychiatric diagnosis in the United
States."
B. "Hwa-byung is a culture-bound syndrome related to suppressed anger in Korean
culture, but Ms. Park's symptoms of grandiosity, decreased sleep, and pressured speech
are more consistent with a manic episode of bipolar I disorder. We can address both the
biological illness and your family's cultural concerns." [CORRECT]
D. "Korean cultural concepts are not relevant to psychiatric diagnosis in the United
States."
Correct Answer: B
Rationale: Cultural competence requires validating the family's cultural framework while
providing accurate psychiatric diagnosis. Hwa-byung involves somatic symptoms and
suppressed anger, not the classic manic symptoms seen here. Dismissing hwa-byung
(A), misdiagnosing (C), or ignoring culture (D) are all culturally insensitive.
Q4: Ms. Park's hospital records indicate that during her manic episode, she had periods
where she simultaneously met full criteria for mania and experienced prominent
depressive symptoms including suicidal ideation, guilt, and psychomotor retardation.
Which specifier best applies to her presentation?
A. With anxious distress
B. With mixed features
C. With rapid cycling
D. With catatonic features
B. With mixed features [CORRECT]
D. With catatonic features
Correct Answer: B
Rationale: Mixed features specifier applies when full criteria for mania/hypomania are
met alongside prominent depressive symptoms. Anxious distress (A) involves anxiety
Treating Bipolar Disorder | Korean Descent Woman
Post-Mania Hospitalization | 25 Clinical Questions | Pass
Guaranteed - A+ Graded
Part One: Diagnosis, Differential & Cultural Formulation (Korean Descent,
Post-Hospitalization) (Questions 1–9)
Q1: Ms. Park, a 26-year-old woman of Korean descent, presents for her first outpatient
appointment following a 21-day psychiatric hospitalization. During hospitalization, she
was described as having elevated mood, grandiose beliefs about her musical talent,
decreased need for sleep (sleeping 2–3 hours nightly for 10 days), pressured speech,
flight of ideas, and excessive spending on musical equipment she could not afford. She
denied hallucinations or delusions. Her symptoms caused significant impairment and
required hospitalization. Based on DSM-5 criteria, which diagnosis is most appropriate?
A. Bipolar II disorder, current episode hypomanic
B. Cyclothymic disorder
C. Bipolar I disorder, current episode manic
D. Borderline personality disorder
C. Bipolar I disorder, current episode manic [CORRECT]
D. Borderline personality disorder
Correct Answer: C
Rationale: A manic episode lasting at least 7 days (or any duration if hospitalization is
required) with marked functional impairment defines Bipolar I. Bipolar II (A) requires
hypomania, not full mania, and a major depressive episode. Cyclothymia (B) involves
subthreshold symptoms without full manic episodes. Borderline PD (D) features mood
reactivity lasting hours, not the sustained week-plus mania seen here.
,Q2: During the intake interview, Ms. Park reports that prior to her manic episode, she
experienced a 2-week period of profound sadness, anhedonia, fatigue, hypersomnia,
and feelings of worthlessness. These symptoms resolved approximately 3 weeks
before the manic episode began. Which statement best describes the diagnostic
implication of this history?
A. The prior depressive episode rules out bipolar disorder and suggests major
depressive disorder
B. The depressive episode supports a diagnosis of bipolar I disorder, as major
depressive episodes commonly occur in bipolar I
C. The depressive episode is irrelevant to the diagnosis since only manic symptoms
matter for bipolar I
D. The depressive episode indicates schizoaffective disorder rather than bipolar
disorder
B. The depressive episode supports a diagnosis of bipolar I disorder, as major
depressive episodes commonly occur in bipolar I [CORRECT]
D. The depressive episode indicates schizoaffective disorder rather than bipolar
disorder
Correct Answer: B
Rationale: Major depressive episodes are common in bipolar I and support rather than
contradict the diagnosis. They do not rule out bipolar disorder (A) or indicate
schizoaffective disorder (D) without psychotic features persisting outside mood
episodes. Depressive episodes are clinically relevant (C is wrong).
Q3: Ms. Park's mother attends the appointment and expresses concern that her
daughter's behavior during the manic episode was "shameful" and "embarrassing to the
family." She asks if this could be "hwa-byung," a condition she has heard about in the
Korean community. Which response by the PMHNP best demonstrates cultural
competence?
A. "Hwa-byung is not a real diagnosis, so we should focus on bipolar disorder."
, B. "Hwa-byung is a culture-bound syndrome related to suppressed anger in Korean
culture, but Ms. Park's symptoms of grandiosity, decreased sleep, and pressured speech
are more consistent with a manic episode of bipolar I disorder. We can address both the
biological illness and your family's cultural concerns."
C. "Your daughter definitely has hwa-byung, not bipolar disorder."
D. "Korean cultural concepts are not relevant to psychiatric diagnosis in the United
States."
B. "Hwa-byung is a culture-bound syndrome related to suppressed anger in Korean
culture, but Ms. Park's symptoms of grandiosity, decreased sleep, and pressured speech
are more consistent with a manic episode of bipolar I disorder. We can address both the
biological illness and your family's cultural concerns." [CORRECT]
D. "Korean cultural concepts are not relevant to psychiatric diagnosis in the United
States."
Correct Answer: B
Rationale: Cultural competence requires validating the family's cultural framework while
providing accurate psychiatric diagnosis. Hwa-byung involves somatic symptoms and
suppressed anger, not the classic manic symptoms seen here. Dismissing hwa-byung
(A), misdiagnosing (C), or ignoring culture (D) are all culturally insensitive.
Q4: Ms. Park's hospital records indicate that during her manic episode, she had periods
where she simultaneously met full criteria for mania and experienced prominent
depressive symptoms including suicidal ideation, guilt, and psychomotor retardation.
Which specifier best applies to her presentation?
A. With anxious distress
B. With mixed features
C. With rapid cycling
D. With catatonic features
B. With mixed features [CORRECT]
D. With catatonic features
Correct Answer: B
Rationale: Mixed features specifier applies when full criteria for mania/hypomania are
met alongside prominent depressive symptoms. Anxious distress (A) involves anxiety
