Boil the pasta: Bring a large pot of well-salted water to a rolling boil.
Add the fettuccine and cook until just shy of al dente according to the package. Reserve about 1 cup of the pasta water, then drain.
Season the chicken: While the pasta cooks, season the chicken on both sides with 1 teaspoon salt, pepper, and garlic powder if using.
Sear the chicken: Heat a large skillet over medium-high heat. Add olive oil, then the chicken.
Sear until golden and cooked through, about 4–6 minutes per side depending on thickness. Transfer to a plate and rest for 5 minutes, then slice into strips.
Start the sauce base: Reduce the heat to medium. In the same skillet, add butter.
When melted, add garlic and sauté for 30–45 seconds until fragrant but not browned.
Add the cream: Pour in the heavy cream and bring to a gentle simmer. Stir in the nutmeg and the remaining 1/2 teaspoon salt. Let it bubble lightly for 2–3 minutes to thicken slightly.
Incorporate the cheese: Lower the heat to medium-low.
Add the Parmesan in small handfuls, stirring until smooth. If the sauce is too thick, add a splash of reserved pasta water to loosen.
Add pasta and chicken: Add the drained fettuccine to the skillet and toss to coat, adding pasta water a little at a time until the sauce lightly clings to the noodles. Fold in the sliced chicken and any plate juices.
Taste and finish: Adjust seasoning with salt and pepper.
If you like, squeeze a little lemon over the top to brighten. Garnish with parsley and extra Parmesan.
Serve immediately: Alfredo is best hot off the stove when the sauce is glossy and silky.