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Vanilla FNV does not have the LAA flag set and will not use more than *2.0 GB* of RAM.
And the 4GB patch will not allow you to access more than 4 GB of RAM (not 4.5) as FNV is a 32 bit application.
There's likely some incompatibility between W10 and 4GB NV (though, make doubly sure that you're using the correct version of 4GB - there's two on the Nexus and one is defunct and not supported anymore but the authors won't take it down, even though they're the same guys who did the more recent version) but W10 is simply too new.
http://www.nexusmods.com/newvegas/mods/55061/?
Any problems you are having would be better addressed there.
Rclick on icon ans select 'Run as Administrator'.
Or run in W7 comp mode.
RAM or VRAM?
It doesn't matter if you have 16GB or or 64GB. FNV is a 32bit program and can only access a total of 4GB of RAM. That total includes both VRAM and system RAM. The task manager might be showing the process using 2.5GB of system RAM, but it is also loading textures into VRAM. If the VRAM usage is over 1.5GB you will crash because 2.5GB of system RAM plus 1.5GB of VRAM is 4GB total.
Also keep in mind, even though a 32-bit process should be able to access up to 4GB of RAM, most of the time they don't work well or crash if they try to use more than around 3.5GB.