Final answer:
The inability to swallow on command is most likely to predict aspiration in a patient presenting with stroke-like symptoms.
Step-by-step explanation:
In a patient presenting with stroke-like symptoms, the inability to swallow on command is most likely to predict aspiration. Aspiration occurs when food, liquid, or saliva enters the airway instead of going into the stomach during swallowing. It can lead to serious complications such as pneumonia.
When a patient is unable to swallow on command, it suggests a dysfunction in the muscles and nerves involved in the swallowing process. This can increase the risk of food or liquid entering the airway, which can lead to aspiration.
To further confirm the likelihood of aspiration, a formal swallowing evaluation may be conducted, which involves assessing the patient's ability to swallow different textures and consistencies of food and drink.