Multiple Choice Questions

Correct answer
Distractors: plausible, three options shows no psychometric difference from four options (Royal, K & Dorman, D. (2018). Comparing item performance on three versus four option multiple choice questions in a veterinary toxicology course. Vet. Sci., 5, 55.)

Assesses application of knowledge (Bloom’s ‘apply’ level or above)
Has one best answer that requires a high level of discriminating judgement (student required to discriminate from among plausible alternatives)
- Use words like most important, first, highest-priority or require students to calculate
Uses unambiguous language
Uses common misconceptions as distractors
Includes rationale for each test item (available after students complete)
Multi-logical thinking – requires knowledge of more than one fact, apply concepts to clinical problem
Options are short or of the same length
Stem contains the relevant information not the alternatives

Using “all of the above” or “none of the above”, or complex options “A and C” or “B, D and A”
Using negative, or double negatives ( If a negative cannot be avoided mark it clearly)
Is really a series of T/F questions (eg. Which of the following about calf starter grain is correct?)
Implausible alternatives
Correct answer longer than distractors
Cluing in alternatives (grammatical, logical, syntax)
Knowledge or memorization based

Which assessment finding is most important in determining nursing care for a client with COPD? (versus knowledge-only variant: Which assessment finding would the nurse expect a client with COPD to exhibit?)
The nurse is making a home visit to a 75-year -old male client who had had Parkinson’s disease for the past five years. Which finding has the greatest implication for the client’s care? (versus fact-based question: The nurse knows that which assessment finding is characteristic of a client with Parkinson’s disease?)

Educational Support Services – Knowledge Base