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I had the same problem and fixed it. Go to my documents / my games and delete the Fallout 4 folder. Also I forced the game to start with admin rights.. dunno if that fixed it or not. But after deleting the folder everything worked fine for me.
Hope that helps!
If the Windowed Mode is ticked and greyed out and can't be un-ticked you have to un-tick Borderless then go above and reapply the correct Resolution then click OK to close the Options panel then click EXIT on the Launcher.
Load the Launcher again and select Options once more. Windowed Mode should now be clickable. It should stay that way from now on.
Check your protection history.
ye that has happened way in the past for many games. Especially if you rebuild a system from back-ups.
Either set the scale to 100% or set the .exe files to override. See here for some info:
https://steamcommunity.com/app/377160/discussions/0/4364626348100218422/#c4364626348100326950