Checked fuel pressure. When hitting the key just to prime it, I got 40lbs. I let it set for about 20 minutes and it stayed there. While running, it was just above 50. My gauge didn't have a dump valve on it to try that exact method. And of course the thing didn't even stumble when I had the gauge on it. Before I pull the bed and tackle the pump I may try this with a different gauge.
In the mean time I figured I would check plugs... two were loose. They're original to my knowledge I'm changing them regardless being there's just under 160,000 on the truck.