Not sure the North American settings thing but if you want custom then select custom from the menu. Then for RGB, you want your calibrated monitor setting, look for it. Then for CYMK you want US WEB COATED SWAP v2, greyscale you want gamma 2.2 and dot gain at 20%.
For profiles, I chose to preserve the embedded profiles. That way, if I screw up settings or get someone else's I'm not screwing with their set colors.