Hi Nathan
After reading your post I assumed that this would work but had not tested that setting until just now.
Unfortunately, even though I have it set to Roads and Highways, when I click F1 while hovering over a button like Realign in the Routes button group of the Location Referencing ribbon tab the help page that opens in my browser is still that of Pipeline Referencing.
I think the F1 key not taking me to the correct documentation is a bug.
- Graeme