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The RTX card driver is as old? dates missing, may wanna look into updating both minus 1 year at least, if both on board drivers are around 2022.
.NET. Visual C. Older Direct X installs. Windows Updates.
At the launcher, get the settings to as low as possible. Enter safe mode (now I don't remember how to do it, I'm not at home).
But I would bet it's some issue with the GPU and/or drivers. Some time ago my GPU got new drivers but also a new software. The drivers updated only to a point but not the software. Everything went crazy. But a quick software change (radeon app) and new drivers and all was well.
that was before the update.
maybe roll back and see if the original game works.
try monitor=60hz and fps=60.
try 1920x1080 for both Primary Display Resolution and Desktop Resolution
some users found windows defender AV blocked the game after the update. check antivirus log in case you are one of them.
If you retained the same hard drive and same FO4 installation after your upgrade, then perhaps you need to delete all of the mods except Loader Accelerator (which has since been updated). Uninstall/reinstalling the game usually does not delete mods.
one work around is to run the game in windowed (border less) mode, this seams to fix alot of startup/loading and the resolution based issues
the only problem is the window resolution may be lower than your monitor, usually 720 by default, to make it the same size as your monitor you can change the window size in the Fallout4Pref.ini file on lines 44/45 under iSize H= and iSize W=
https://steamcommunity.com/sharedfiles/filedetails/?id=3241230342
You can also use GeForce Experience or NVIDIA App and have it optimise the game's settings for you. This may do the trick, too. And it also disables weapon debris.