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NCAC II competencies emphasize comprehensive, multidomain assessment and safety-first triage. Cognitive complaints warrant a brief cognitive screen within scope (e.g., orientation checks, simple recall tasks), while you map the onset and fluctuation of symptoms relative to substance use—particularly alcohol, which can cause blackouts or longer-term neurocognitive effects. With informed consent, collateral from medical records or family can validate history and identify head injury, withdrawal seizures, or nutritional deficits. A medical evaluation is indicated when cognition appears impaired, because this impacts capacity for informed consent, learning, and safe participation. Option B integrates these steps to guide level-of-care and risk management. Option A is dismissive and risky. Option C ignores immediate functional concerns. Option D is premature and outside scope without medical workup. Findings from the screen inform pacing, repetition, and written supports during treatment, and they help tailor goals (e.g., shorter sessions, visual aids) while coordinating with healthcare providers.