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In the context of a patient presenting with chest pain, an Emergency Nurse Practitioner (ENP) should prioritize immediate ECG assessment. This is crucial because chest pain can be indicative of serious conditions such as myocardial infarction (heart attack) or other cardiac events. The ECG is a rapid and effective tool for identifying any abnormalities in heart rhythm, signs of ischemia, or infarction that require urgent intervention. Timely ECG interpretation can directly influence treatment decisions, potentially saving the patient's life by guiding immediate therapeutic measures such as medication administration or preparation for procedures like angioplasty.

While gathering a medication history, conducting a full physical examination, and implementing patient comfort measures are all important components of patient care, they come after establishing the immediate need for life-saving interventions. Effective management of chest pain hinges on quick identification of potential cardiac issues, making the ECG assessment a priority in this situation.