I used to do a lot of US "translations" for a well known cosmetics manufacturer, so I know exactly what you are facing. There are no hard and fast rules, but there are several rules of thumb.
1. Remember that your goal is to maintain the priority claim to the PCT, and that a true 371 national phase application cannot contain new matter. If your translation is so far afield of the PCT that it describes subject matter that was not expressly, implicitly, or inherently described (the standard for new matter in the US) in the PCT, that can be a very bad situation. Think of it as being akin to a CIP of a U.S. application. This means that generally, a translation of a PCT application that will enter the US under 371 should be as close as possible to an exact translation of the PCT application itself.
2. I think it is permissible to change words, sentence structure, etc. to conform with industry standard language and English grammar, PROVIDED THAT RULE #1 IS NOT VIOLATED. When in doubt, propose the changes to your client, fully inform them of the risks, and get their confirmation of the changes IN WRITING. In fact, the practice suggested in the previous sentence is probably the best practice, whether or not you doubt the accuracy of your translation.
3. Note that there is an alternative to entering the U.S. national phase via 371. Specifically, you can file a U.S. continuing application from the PCT, so long as the PCT is still pending (i.e., prior to 30 months from the filing date of the PCT). This practice provides several benefits, not the least of which is that the continuation can be an inexact translation of the PCT, and can contain new matter (in which case it would bea CIP of the PCT). See MPEP 1895 and
http://www.aipla.org/learningcenter/library/papers/roadshows/pct10/Documents/tab_8.pdf (page 16)
As to your questions re: section headings, the U.S. rules and MPEP suggest, but do not require, the use of section headings. Moreover, a statement of the "background" is not required, and is often omitted by some practitioners. To my knowledge, there are no hard and fast limits on the use of section headers.
You asked about what will happen if the examiner thinks you went too far. The answer might depend on the circumstances. In some cases, the examiner might simply give you a new matter rejection. In other cases, the examiner could find that your priority claim is invalid. In either case, you should be able to amend the U.S. application to correct the issues underlying the rejection or denial of the right of priority. Such corrections would typically come in the form of amendments that rely on the original text of the PCT.