Cook the pasta: Bring a large pot of salted water to a boil. Cook protein pasta according to package instructions. Drain and set aside.
Make the pesto: In a food processor, combine basil, Parmesan, garlic, and nuts. Pulse while gradually adding olive oil until smooth. Season with salt and pepper.
Cook the turkey: Heat olive oil in a large skillet over medium heat. Add ground turkey, season with salt and pepper, and cook until browned, about 6–8 minutes.
Combine everything: Add cooked pasta and pesto to the skillet with turkey. Toss until evenly coated. Stir in cherry tomatoes or spinach if using.
Serve: Plate while warm. Top with extra Parmesan or a drizzle of olive oil if desired.