I have two projects ones a class library and ones an mvc3 project. They both have nuget packages associated with them. On the class library when I right click the solution
The NuGet package restore context menu item is hidden when the extension detects the presence of a $(SolutionDir).nuget folder containing the nuget.exe, nuget.config and nuget.targets needed to perform package restore.
The MVC app already has these, so restore should be enabled. If not, simply delete the .nuget folder and you'll see the menu item reappear.
For me it was as simple as:
"Manage NuGet Packages for Solution" -> "Restore" (top right of dialog)