- First thing is, when the engine is cold, open the coolant fill, and see if the coolant is right up to the lid, or if there is lots of air in there. Air is a bad sign. But it's not a sure sign (as air can also be drawn in if there is an external coolant leak somewhere).
- Next, start the engine, and feel the upper rad hose. If it gets really hard right away, that is a bad sign (system being pressurized). Again, this can happen if there is air in the system from an external coolant leak, but the pressure will dissipate after a bit.
- Allow the engine to keep warming up, and carefully remove the cap off the coolant reservoir keeping the tube inside immersed in the coolant. Move the lid to the side a bit so you can see in, and watch around the tube in the coolant. Look to see if bubbles are coming out. If there was just a bit of air in the system, you may see a couple bubbles. But if the bubbles keep coming, it's a head problem.
- Take it for a drive. Load the engine by going up a hill on the highway or similar. Watch the temperature gauge carefully - make sure it only goes to 1/3 of the scale and does not jump around or go higher. Stop somewhere shortly after (leaving the engine idling) and take a look at the coolant reservoir. Make sure the level has gone up just a little bit. If the reservoir is full or overflowing, it's a sure sign of a head problem. You can also feel the upper rad hose again, and check for bubbles in the overflow reservoir again. Careful not to burn yourself. A hard rad hose and bubbles still coming is a sure sign of a head problem.
A bad head is not the end of the world if you are mechanically capable. You can use it to get the truck really cheap, and put a new head on yourself. Then you'll have good confidence afterwards anyhow.