without the FULLY splinned mainshaft, the new nut is only a temporary fix. I would spend the extra $40 and get the fifth gear too if this is the route that you are chosing. That will make it last a little longer.
Here is my experience with a friends truck.
1. 106k fith gear nut falls off, we installed new "updated nut"
2. 110 updated fifth gear nut falls off. We install new nut and fith gear at the same time.
3. Just last week a 122k fifth gear fell off again, we ordered the fully splinned shaft and rebuild kit for the NV5000.
Hopefully you will have better luck.
Mine fell off at 94k and I fixed it with the fully splinned shaft and new fifth gear. I am at 110k now with many hard miles with no problems.
edit: it really doesn't have anything to do with the nut itself. When the short splines become worn, the fifth gear itself will start to rotate back and forth as you give fuel and then let off. It is this rotating action that loosens the nut. Short or welding it in place a new nut is just a patch that tries to cover up the real problem.