01 - Cook fettuccine in large pot of salted boiling water according to package directions until al dente. Reserve 1/2 cup pasta cooking water before draining.
02 - Heat 1 tbsp olive oil in large skillet over medium-high heat. Season shrimp lightly with salt and pepper, cook 2-3 minutes per side until pink and opaque. Remove from skillet and set aside.
03 - Reduce heat to medium. Add butter and remaining 1 tbsp olive oil to skillet. Sauté minced garlic for 30 seconds until fragrant.
04 - Pour in heavy cream and bring to gentle simmer. Add Parmesan, black pepper, salt, and nutmeg if using. Simmer 2-3 minutes, stirring constantly, until slightly thickened.
05 - Add drained fettuccine to sauce, tossing gently to coat. Add reserved pasta water as needed to achieve desired consistency.
06 - Return shrimp to pan and toss to combine. Stir in chopped parsley. Serve immediately, garnished with extra parsley and lemon wedges if desired.