Upon examination of a driver with xanthelasma palpebrarum, which test should be performed?

Xanthelasma palpebrarum, characterized by yellowish, cholesterol-rich deposits around the eyelids, can be indicative of underlying lipid metabolism disorders. When a driver presents with xanthelasma, it is essential to assess the potential for dyslipidemia, which can increase the risk of cardiovascular diseases.

Performing serum lipids and cholesterol tests is critical because it helps to identify abnormal levels of lipids—such as high cholesterol or triglycerides—in the blood. High levels of these lipids could point to conditions that require management to reduce cardiovascular risks. Therefore, by focusing on serum lipids and cholesterol levels, healthcare providers can better understand the driver's overall health and the potential implications for driving safety.

The other options, while they may have their own importance in different clinical scenarios, do not directly relate to assessing the concern raised by the presence of xanthelasma. Blood pressure measurement, serum creatinine tests, and chest X-rays would not provide the relevant information needed to address issues of lipid metabolism and cardiovascular health associated with xanthelasma.