The fantasy world I'm working on has no name yet, but when I do name it, it will probably be something along the lines of 'earth'; just something pertaining to the very fundaments of nature on which human and humanlike cultures depend. Then I might translate this into the different tongues of the world.
The nations, however, have names. Weird names just enter my head, and if I like the sound of them, I use them for whatever region they suit. A few of the languages in my world are under development and they are never based solely on one real world language, so pretty much everything sounds pretty 'foreign' and yet, at times, familiar (since I don't really try to invent new phonemes, haha). At any rate, most of these names popped up before any of the languages had been defined at all, so I retroactively give them meaning, using the names to 'activate' the vocabularies.
Also, the larger or more important a region is, the more likely is it that I will try sticking to names that are easy to remember and to pronounce, while truly complex names still are viable for less 'central' locations.
Apart from that, I'm highly 'simulationist' in that I really don't care whether English speakers or (as in the case with most of my friends) Swedish speakers find the names challenging.
To illustrate my perspective: I have a hard time pronouncing (or merely grasping the fundamental ortography of) for example Romanian, even though it is an Indo-European language with a lot in common with, for example, Italian, French and Latin (all of which are languages we come across frequently for a number of reasons). On a completely different level we have the vast majority of languages that aren't even remotely related to English or Swedish.
Thus, I believe that in a 'realistic' fantasy world it is nigh inconceivable that all of the place names would be easy to grasp for the average person.
Personally, I feel that for example Al-Qahirah is much preferrable to Cairo (one and the same). I have names like this in my world (not Arabic, but distinctly non-European). The Q represents a phoneme in its own right and to replace this with something more 'Germanic-friendly' makes zero sense in a fantasy world, I think.
I didn't mean for this devolve into a linguistic discussion but there you have the basis of my perspective.
If I want a name to convey a 'cold' feel, I don't have to look to ancient Norse or Greenlandic, because the very sounds of a name (that I can make up instead of assembling from real world names) can convey it. If, on the other hand, I specifically wanted to convey an unmistakably ancient Norse feel, well... I wouldn't.