The greatest concern associated with a high number of IT policy exceptions approved by management is that the exceptions may result in noncompliance. IT policy exceptions are deviations from the established IT policies that are granted by management for specific reasons and circumstances. However, if there are too many exceptions, it may indicate that the IT policies are not aligned with the business needs, regulatory requirements, or best practices. This may expose the organization to legal, contractual, or reputational risks due to noncompliance. The other options are not as concerning as noncompliance, as they do not have the same potential impact or consequences. The exceptions are likely to continue indefinitely is a possible outcome of a high number of exceptions, but it does not necessarily imply a negative effect on the organization. The exceptions may elevate the level of operational risk is a valid concern, but it can be mitigated by implementing compensating controls or monitoring mechanisms. The exceptions may negatively impact process efficiency is a minor concern, as it does not affect the effectiveness or reliability of the IT processes. References: CISA Review Manual (Digital Version), Chapter 3, Section 3.2