Providing an update.
Since my last post, I replaced the cap, rotor, and plug wires. No CHANGE. Misfire is still present under the higher load/throttle and incline scenario, and it is more noticeable (truck shaking, loss of power & speed, etc).
I've done extensive research on other forums and YouTube videos of similar issues, as well as on different vehicles with a similar problem and have seen several mentions of faulty sensors such as the Knock Sensor, TPS, etc.
With as much $$$ I've previously put into MPFI repairs (3 MPFI kits so far in 8 years) this issue creeps back until it becomes so bad that I can't drive the truck.
I did take the truck to a local shop in TN (recently moved here) and from the minor diagnostics they have done so far (planning to do more) they believe its the MPFI nozzles again OR the cam shaft is worn enough to cause misfiring on Cyl 3, 4, 5 & 7 where I see the counters go crazy when it does it.
The shop is going to give me an estimate to diagnose deeper into the engine. I know its gonna be $$$$.
What are the chances, that its something super simply like the Knock Sensor throwing everything off?
I'm tired of the problem being "fixed" by a shop for about a year or so and then returning with a vengeance.