"Verify integrity of game cache" fixed this for me, it found one file it did not like the looks of and replaced it.
History:
I had started the game one time, played a bit, saved and exited and it hung. Left for a couple of hours and had a notice when I came back that it had stopped working

, yeah, that is what I told it to do it just did not want to go away at the time. Started it back up to the FalloutNV.exe stopped error, tried again to same result, rebooted, same result, looked here for answers. Game on.
Windows 7 Professional 64-bit, Athlon 64 X2 5200+, Nvidia 9800 GTX+.