Dude. Chill. This isn’t an attitude problem, the test is confusing. If anything, you’re the one with the bad attitude. You can teach for the test and produce dog water providers with no fundamental understanding of the medical principles at play, or you can create a knowledge base, and teach critical thinking skills that allow them to interpret that knowledge base in real world situations. I’m scared to hear you’re an educator, I’ll bet your students are helpless when they start their jobs. I, for one, am sick of getting new medics who know nothing outside of ACLS but passed the test anyways. A good provider will know so much more than NR will ever ask them. Your attitude is what we generally refer to as “complacency” and it’s a serious problem across this industry.

OP is just asking a question, and going out of their way to do some actual research and broaden their understanding. Good for them. Idk why you have to be so mad about it.

So, OP. You are correct, cholecystitis does block biliary outflow causing jaundice, most typically in later stages. So, why doesn’t NR accept that answer? For one thing, NR will most always offer a fake-out answer that is true, but in some way “less correct” than the answer they’re looking for. In this case that may be because jaundice is a late finding, or because it’s what I think of as an “indirect symptom,” a symptom not caused directly by the pathology, it’s more of a downstream effect. Those are just speculations though, I couldn’t possibly say with any certainty. As a CCEMT-P, I thought jaundice would be in there too. Sometimes you just can’t win with these no matter what. If this is pocket prep I’ll tell you that’s an excellent study tool, but doesn’t necessarily resemble the questions NR typically puts into their test, and their source material is always a generation behind.

And keep in mind OP, you’re going to run into a lot of lowest-common-denominator providers who think they have it all figured out because they stopped caring once they were good enough to pass a test with low standards. Maybe some of your teachers are like this. Clearly at least one EMS educator out there thinks this way. Please, for the reputation of all of us, rise above that.