A school nurse is assessing a 7-year-old student. The nurse should identify which of the following findings as a potential indicator of physical abuse?

The correct answer is D: Bruising around the wrists. This finding is concerning for physical abuse because bruises around the wrists are not commonly seen in accidental injuries. These bruises may indicate that the child was grabbed or restrained forcefully. It is crucial for the nurse to further assess the nature, location, and pattern of the bruising to determine if it raises suspicion of abuse. Abrasions on the knees (choice A) are more likely to be related to normal childhood activities. Front deciduous teeth missing (choice B) is a common occurrence in children due to natural tooth loss. Weight in the 45th percentile (choice C) is within the normal range and does not specifically indicate physical abuse.