A nurse is caring for a client who has bulimia nervosa. Which of the following actions should the nurse take first?

A. Correct. Observing the client during and after meals is a priority because clients with bulimia nervosa often engage in episodes of binge eating followed by purging behaviors. Monitoring the client's behavior during meals and immediately after can help assess for potential purging behaviors. B. Incorrect. While involving the client in meal planning might be helpful, it is not the first action to address potential purging behaviors. C. Incorrect. Instructing the client about effective coping strategies is important, but observing for potential purging behaviors is the initial action to address the client's immediate safety. D. Incorrect. Referring the client to a support group is beneficial, but it is not the first action to address the client's immediate risk of purging behaviors.