A nurse is contributing to the plan of care for a recently admitted client who has bulimia nervosa. Which of the following interventions should the nurse recommend including in the plan of care for the first week of hospitalization?

A. Supervise the client during mealtimes is a key intervention during the first week of hospitalization for bulimia nervosa. Supervision helps prevent purging behaviors such as vomiting, excessive exercise, or misuse of laxatives. It also provides an opportunity for the nurse to encourage structured eating, reinforce healthy coping strategies, and assess the client’s adherence to the treatment plan. B. Punishing the client for purging behavior is inappropriate and ineffective. Punitive approaches can increase shame, anxiety, and resistance to treatment. Therapeutic interventions focus on support, education, and behavioral strategies rather than punishment. C. Permitting the client to select their own meals early in hospitalization can increase the risk of purging and is not recommended until the client demonstrates improved control over eating behaviors and adherence to the structured meal plan. D. Assigning the client independent bathroom privileges immediately after meals increases the risk of purging and is unsafe during the initial phase of treatment. Bathroom privileges are typically restricted for a period after meals until the client demonstrates improved self-regulation and compliance.