beginning of content:

Each item should:

  • Have one and only one correct answer.
  • Be grammatically correct.
  • Test what it sets out to test.
  • Be clear and unambiguous in wording and concept—there should be no other possible meaning.
  •  Be free of clues to the right answer.
  • Not give away the answer to another question in the same set.
  • Be appropriate in language and content for the population being tested.

The stem of an item should:

  • Consist of an incomplete statement or a question.
  • Contain no extraneous material.
  • Contain words or phrases that would otherwise have to be repeated in each option.
  • Contain sufficient material to indicate the basis on which the correct option should be selected (in other words, students should be able, in theory, to provide a correct answer based on the stem even before they see the options).
  • Be positive, if possible (i.e., not contain negative wording, such as "Which of the following is NOT" or "All of the following are true EXCEPT"). The wording of the question should not in itself pose problems of logic for students. Occasionally, questions with "negative" stems do appear on the exams, but only when this is the most logical and least confusing way to word a question.

The correct answer to an item should:

  • Be clearly correct and the "best" choice.
  • Contain a single idea.
  • Clearly convey its meaning.
  • Be of approximately the same length as the distracters (incorrect options).

The distracters to an item should:

  • Be relevant to the stem of an item.
  • Be plausible but incorrect in terms of the requirements of the stem.
  • Be plausible but incorrect in terms of the candidate's level of knowledge.
  • Be comparable to one another in form and difficulty but different in content.
  • Clearly convey their meaning.

Note: "None of the above" should not be used as an option; nor should a list of possible answers be provided with the instruction to select whether one, two, three, or four of them are correct.