A nurse is collecting data from a client who has peptic ulcer disease. Which of the following findings is a manifestation of gastrointestinal perforation?

A. Bradycardia: Gastrointestinal perforation usually triggers tachycardia due to hypovolemia, pain, and shock. Bradycardia is not typical in this context. B. Severe upper abdominal pain: Perforation causes sudden, severe, and rigid abdominal pain due to leakage of gastric contents into the peritoneal cavity, resulting in peritonitis. C. Hyperactive bowel sounds: Perforation typically causes absent or hypoactive bowel sounds because intestinal motility ceases in peritonitis. Hyperactive sounds are more typical of obstruction or early gastritis. D. Report of epigastric fullness: Epigastric fullness is a common symptom of dyspepsia or non-complicated ulcer disease. It is not indicative of the acute, life-threatening complication of perforation.