All those dire scenarios are possible, but before you get too upset, assuming oil pressure seems OK, I'd suggest the first step is a good oil-based flush. Here's what I've done a couple of times in the past. Get a cheap filter and some cheap thin high detergent oil, and do an oil change. Now run the car up to a good heat for a good long day, maybe a hundred miles or so. Now change the oil hot, and put in a really good filter ( I like Wix), and good quality oil. Sometimes this will flush out dirty lifters. Even if it doesn't, you've given your engine a nice harmless flush.
Don't confuse valve clatter with piston slap, which is a common issue with some 4.0's and not really a worry. Piston slap will get quieter when the engine heats up, while valve clatter will often get worse when it's hot and idling. Some do it like crazy, others not at all. My 95 was terrible, my stepson's 93 middling, the 99 quiet and the 87 silent. They all went well over 200K miles. If you do have piston slap, make sure you keep an eye on the water pump too, because I found that the sound of a bad water pump can be masked by a slappy engine.