Final answer:
Symptoms of an obstruction distal to the ampulla of Vater can include sudden onset of severe vomiting.
Step-by-step explanation:
Symptoms of an obstruction distal to the ampulla of Vater can include sudden onset of severe vomiting. In this case, the nurse is taking a health history of a 2-year-old girl presenting with a sudden onset of severe vomiting, which could suggest an obstruction distal to the ampulla of Vater.