With your card:
Global settings:
Ambient occlusion: on
Supersampling transparency AA
16xQ AA
16x AF
Clamp: on
Texture filtering: High Quality
Anisotropic samp opt: OFF!
Except in Crysis? With my 260, almost all games can handle the settings cranked except for anisotropic filtering.
I'm not at home right now, but those are the settings I can think of off hand.
Vsync/triple buffering work hand-in-hand. Only use if you prefer vsync. Also, if you do use vsync, try to use the Nvidia control panel vsync over an in-game vsync. (Be sure to disable vsync in-game if doing so.) The Nvidia vsync will stop mouse lag problems associated with game manufacturers vsync. For me, some game must be vsync because of horrible screen tearing, other games are not so bad and do not need to be sync'd.
Hope this helps! You can really make games shine with manual panel settings.