Truck runs very very rough

[Cdncarnut]

I do not think that it is the fuel filter as that will just cause it to stall.
It sounds like it is not running on all cylinders.
Bad plug, bad ignition wire, bad distributor cap, EGR valve stuck open, possibly even a defective distributor module.

 

[Sad Sack]

I was unaware the q-jets had actual idle screws I think it could possibly be nasty fuel that clogged it since she was running a little low on fuel about a quarter tank when I stopped at the gas station put some fuel in her and she’s been running like ass ever since

Put gas in and then runs like crap, POSSIBLY either sucked up some bottom of the tank crap or water in the tank from filling up?

Were any tankers blasting gas into the ground when you were there filling up?