I tried Compatibility Mode with all of the various Windows versions it listed. 
 
I have discovered that the problem has something to do with AMD.  I have 4 computers at home.  3 are Intel of various CPU amd MB versions.  My main desktop is an AMD R9 3950X.  The CAD program will run on the Intel systems but not on the AMD system.  They are all running the same Windows version. On the Intel systems it throws a message saying it couldn't update the Registry but it starts successfully anyway.  This odd since the program is pre-Registry.  The problem is due to waiting for a response from splwow64.exe.  Weird.

EVGAuser97428
I tried Compatibility Mode with all of the various Windows versions it listed. 
 
I have discovered that the problem has something to do with AMD.  I have 4 computers at home.  3 are Intel of various CPU amd MB versions.  My main desktop is an AMD R9 3950X.  The CAD program will run on the Intel systems but not on the AMD system.  They are all running the same Windows version. On the Intel systems it throws a message saying it couldn't update the Registry but it starts successfully anyway.  This odd since the program is pre-Registry.  The problem is due to waiting for a response from splwow64.exe.  Weird.

That is odd.

3 days running this optional update KB5034848 with no issue's.  https://www.bleepingcomputer.com/news/microsoft/windows-11-kb5034848-preview-update-adds-usb-80gbps-support/
 

New features in the KB5034848 update

With the release of the KB5034848 update, Microsoft has introduced a total of twenty fixes, changes, and new features to Windows 11.
These new features are not minor tweaks but bring significant changes and customization to the operating system.
The nine highlighted changes in the KB5034848 update are:

• New!  The Phone Link settings page has a new name: Mobile devices. Go to Settings > Bluetooth & devices > Mobile devices.
  
• New! You can now use the Snipping Tool on your PC to edit the most recent photos and screenshots from your Android device. You will get an instant notification on your PC when your Android device captures a new photo or screenshot. To turn this on, go to Settings > Bluetooth & devices > Mobile devices. Choose Manage devices and allow your PC to access your Android device.
  
• New! This update adds support for the USB 80Gbps standard. It is the next generation of USB4 that has twice the bandwidth of USB 40Gbps. To use USB 80Gbps, you must have a compatible PC and USB4 or Thunderbolt™ peripheral.
  
• This update affects games you install on a secondary drive. Now, they remain installed on the drive.
  
• This update addresses an issue that affects long-edge fed printers. The alignment of stapling or hole punch locations is wrong.
  
• This update addresses an issue that affects the Windows Settings Home page. It randomly stops responding when you go to the page.
  
• This update addresses an issue that affects networking. A device fails to make the automatic switch from cellular to Wi-Fi when it can use Wi-Fi.
  
• This update addresses an issue that stops a system from going to sleep. This occurs when you connect an external device to the system.
  
• This update affects the Windows Backup app. It will no longer show on the user interface in regions where the app is not supported. To learn more, see KB5032038.
  

The only known issue in this update is problems installing the KB5034765 update released earlier this month.
"Windows 11 devices attempting to install the February 2024 security update, released February 13, 2024 (KB5034765) might face installation failures and the system might stop responding at 96%," explains Microsoft.
For those affected, you will receive an error in the Windows Event Viewer with error code '0x800F0922'.
To fix the issue, you need to delete the hidden C:\$WinREAgent folder.
 
A complete list of fixes can be found in the KB5034848 support bulletin.
 

Great something in this update caused my Asus PG297Q monitor HD Audio Device to install a bunch of duplicates again in Device Manager even while the single audio device that shows in the Sound Control Panel thing only shows one and it's disabled.  Last time this happened removing the Nvidia HD Audio driver fixed it.  I still don't have that installed either.  I delete the dups, "scan for hardware changes" or reboot, and they come right back.

New Cumulative update KB 5035853 released yesterday.  https://www.bleepingcomputer.com/news/microsoft/windows-11-kb5035853-update-released-heres-whats-new/

What's new in the Windows 11 KB5035853 update

After installing the KB5035853 update, Windows 11 23H2 will have a build number of 22621.3296, and Windows 11 22H2 will be build 22621.3155.
So, what's fixed in the patch? Here's a list of all key changes:

• Microsoft is changing the name of  The Phone Link settings page to Mobile devices. Go to Settings > Bluetooth & devices > Mobile devices.
  
• You can now use the Snipping Tool on your PC to edit the most recent photos and screenshots from your Android device. You will get an instant notification on your PC when your Android device captures a new photo or screenshot. To turn this on, go to Settings > Bluetooth & devices > Mobile devices. Choose Manage devices and allow your PC to access your Android device.
  
• This update adds support for the USB 80Gbps standard. It is the next generation of USB4 that has twice the bandwidth of USB 40Gbps. To use USB 80Gbps, you must have a compatible PC and USB4 or Thunderbolt™ peripheral.
  
• This update affects games you install on a secondary drive. Now, they remain installed on the drive.
  
• This update addresses an issue that affects long-edge fed printers. The alignment of stapling or hole punch locations is wrong.
  
• This update addresses an issue that affects the Windows Settings Home page. It randomly stops responding when you go to the page.
  
• This update addresses an issue that affects networking. A device fails to make the automatic switch from cellular to Wi-Fi when it can use Wi-Fi.
  
• This update addresses an issue that stops a system from going to sleep. This occurs when you connect an external device to the system.
  
• This update affects the Windows Backup app. It will no longer show on the user interface in regions where the app is not supported. To learn more, see KB5032038.
  

This update also addresses a known issue where updates failed to install and displayed 0x800F0922 errors in Windows Update.
For a full list of changes in this update, you can review the KB5035853 release notes.

flyinion
Great something in this update caused my Asus PG297Q monitor HD Audio Device to install a bunch of duplicates again in Device Manager even while the single audio device that shows in the Sound Control Panel thing only shows one and it's disabled.  Last time this happened removing the Nvidia HD Audio driver fixed it.  I still don't have that installed either.  I delete the dups, "scan for hardware changes" or reboot, and they come right back.

Between these issue's and your Nvidia driver issue's, something doesn't seem right with your setup. If it were me, I think I'd start from scratch with a fresh Windows install. Just my perspective.

No issues to report after install of MS - April, "patch Tuesday updates" on W10 Home & W10 Pro

Desktops:  Windows 11 Pro 23H2 (22631.3447) 
Laptop:      Windows 10 Pro 22H2  (14056.4291) 

Just got a few updates this morning for Windows 11 23H2. No issue's to report.
 
.NET Framework Cumulative update ->  https://www.elevenforum.com/t/kb5036620-cumulative-update-net-framework-3-5-and-4-8-1-23h2.24201/
Cumulative update ->  https://www.bleepingcomputer.com/news/microsoft/windows-11-kb5036893-update-released-with-29-changes-moment-5-features/
MSRT update ->  https://www.catalog.update.microsoft.com/Search.aspx?q=kb890830
 

I've been running this https://www.bleepingcomputer.com/news/microsoft/windows-11-kb5036980-update-goes-live-with-start-menu-ads/  optional Windows 11 23H2 update for a couple weeks now. No issue's at all. I don't see any differences from this update I think because most of the big "new" features I already had disabled prior.