What is a key sign to observe for in a physical exam of a patient suspected of having a stroke?

Asymmetrical facial features, such as drooping of one side of the face, are key indicators during a physical exam for a patient suspected of having a stroke. This occurs due to the disruption of blood flow to parts of the brain that control facial movements, often as a result of an obstruction or hemorrhage. When assessing a patient, healthcare providers will typically ask the individual to smile or show their teeth, which can reveal these asymmetries and indicate a potential neurological deficit.

In contrast, the other signs listed do not directly relate to the immediate assessment of a stroke. Respiratory distress might indicate other medical conditions affecting the lungs or airways, abdominal aortic bruit could be suggestive of vascular issues but is not specifically linked to stroke, and a skin rash is typically associated with allergic reactions or other dermatological conditions rather than a cerebrovascular event. Hence, observing for asymmetrical facial features is particularly relevant when evaluating for a stroke.