1989 Chevy 1500 Pickup 2wd - starting and running problems?

[Zach]

1989 Chevy 1500 pickup,2wd, long box, extended cab. 350 engine - Truck starts when it sits for a while and runs, but when i reach high rpm in 1st and 4th gear it is rough and kinda sputters. wont go into 5th gear. (automatic 5 speed) when i reach my destination, i either shut it off or leave it running, but when i go to leave and put it into gear, it shuts off. I go to start it again, and it will try to turn over but wont start. I hear clicking noises and thumps also. When idling, it makes clicking noises also and seems like it is about to die, but then gets back up to the correct rpm. It seemed like it skips time when i start it, but it starts and runs fine sometimes, which would leave me to believe that it wouldn't be the timing chain. This is really getting on my nerves. Any information would help.. (its been in winter months reaching -25 degrees, but today it was 42 degrees and i had same problem)