Came home from work and tweaked a few settings, and now met with total success:
Steps I took to get here:
1) Navigate to Documents>My Games>FalloutNV>Fallout.ini, right click and turn Read Only off
2) Within Fallout.ini, changed values of iSafeZoneXWide, iSafeZoneX, and fDefaultFov to values necessary to properly display your UI and popup screen elements (in this case 900, 900, and 120).
3) Still within Fallout.ini, changed value of bEnableEyefinity to 0.
4) In the same directory within the file FalloutPrefs.ini, changed the values of iSafeZoneXwide, iSafeZoneX, fDefaultFov, and bEnableEyefinity to match the values I set in Fallout.ini.
5) Still in FalloutPrefs.ini, changed iSize W and iSize H to match my resolution (in this case 5760 and 1080).
6) Select All and copied the contents of this file, then navigated to C>Program Files>Steam>userdata>(your UID, probably the only folder in there)>22380(the game ID assigned by Steam to Fallout NV)>remote>falloutprefs.ini , opened this file, select all and pasted the contents of the first FalloutPrefs.ini file into the one I just opened.
7) Saved all files, and set the original Fallout.ini back to Read Only.
The only remaining issue is the blurry text on the PipBoy, troublesome but as long as my UI is in the right damn place finally I'll just live with it. I imagine its possible to use the Fallout 3 text fix for this as well, I just want to finally play the damn game.