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?

A. Weight in 45th percentile: A weight in the 45th percentile falls within the normal range for a 7-year-old child and does not, by itself, suggest maltreatment. Physical abuse is more closely associated with injury patterns rather than isolated growth measurements within expected limits. B. Bruising around the wrists: Bruising around the wrists can indicate the child may have been restrained or forcibly grabbed. Injuries in areas not typically injured during play raise concern for inflicted trauma and are considered potential indicators of physical abuse. C. Abrasions on the knees: Abrasions on the knees are common in school-aged children due to normal play and falls. These injuries usually occur on bony prominences and are generally considered consistent with accidental trauma. D. Front deciduous teeth missing: Loss of front primary teeth is developmentally expected in children around this age. This finding alone is not suggestive of abuse and is usually part of normal dental development.