A client with GERD has been taking omeprazole 40 mg daily for 18 months. The nurse knows that what potential adverse effect is the client as risk for?

A. Exostosis, or bone overgrowth.: Omeprazole, a proton pump inhibitor (PPI), does not cause bone overgrowth or exostosis. This condition is typically associated with chronic irritation or mechanical stress rather than medication use. B. Drug induced ototoxicity.: Ototoxicity is linked to medications such as aminoglycoside antibiotics, loop diuretics, and certain chemotherapeutic agents. Omeprazole does not affect the auditory system or cause hearing loss. C. Osteoporosis-related fracture risk.: Long-term PPI use, such as omeprazole for more than a year, can decrease calcium absorption by reducing gastric acid secretion. This may lead to decreased bone mineral density, increasing the risk for osteoporosis and fractures, particularly of the hip, wrist, and spine. D. Diminished visual acuity.: Omeprazole is not associated with visual changes or ocular toxicity. Any vision changes would more likely stem from other systemic conditions such as diabetes or hypertension rather than prolonged PPI therapy.