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A 55-year-old male patient reports to an outpatient physical therapy gym for a scheduled physical therapy appointment.  The patient has a primary diagnosis of low back pain and has been receiving physical therapy treatment for 3 weeks.  Upon entering the clinic, the patient requests to sit and reports a novel onset of retrosternal chest pain.  Which of the following actions is the MOST appropriate next step?

Ask the patient to report the character of the pain and aggravating factors.  This is the most correct answer.   The first step to appropriately evaluate the patient is to gather more historical data before initiating a physical exam.  The decision to continue treatment or refer to the physician will be dependent upon the historical information and objective findings.  Swain, D. P., & Brawner, C. A. (2018). ACSMs resource manual for Guidelines for exercise testing and prescription (9th ed.). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. P. 45