Review Question - QID 109437

A 14-year-old boy presents to his primary care physician for a general check-up. The patient has attended 2 basketball practices and fainted both times. Otherwise, he is performing well in school. The patient has a medical history of obesity, elevated fasting blood glucose, and high blood pressure. He is not currently taking any medications. The patient's parents want the patient to be cleared medically before he goes back to playing basketball again. His temperature is 99.5°F (37.5°C), blood pressure is 130/87 mmHg, pulse is 81/min, and respirations are 11/min. A physical exam is notable for an obese child who is pleasant and conversational. A pulmonary exam reveals lungs that are clear to auscultation bilaterally. A cardiovascular exam reveals a murmur that is most prominent along the left sternal border. A neurological exam reveals 5/5 strength in the upper and lower extremities with 2+ reflexes. Further diagnostic exams are ordered. Which of the following is the most appropriate management for this patient's chief concern?