I haven't tried anything involving the actual GPU, just the in-game settings before I realized that it was only using a fraction of the GPU.
Again, I run other games absolutely fine max settings, I was even playing FO3 earlier today for hours to get back into the FO swing, no issues.
I wonder... Check the control panel and see if it has New Vegas in the list of games? It might be that it doesn't have preset settings like FO3 does.
In that case... perhaps adding the NV launcher and EXE to the FO3 profile might help? nVidia did release drivers -today- but AFAIK the changelog made no mention of New Vegas.
EDIT: This is getting -very- irritating when you're trying to help people:
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