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- Provides students with several alternatives from which to choose the correct response or
responses.
- Two types:
o Multiple-choice: have one correct answer, are used widely in nursing and in other
fields. This test-item format includes an incomplete statement or question,
followed by a list of options that complete the statement or answer the question.
o Multiple-response: more than one answer may be correct.
MULTIPLE-CHOICE ITEMS
These items have one correct answer, are used widely in nursing and in other fields. This
test-item format includes an incomplete statement or question, followed by a list of options that
complete the statement or answer the question.
a. Stem,
b. Answer, and
c. Distractors.
- The stem is the lead-in phrase in the form of a question or an incomplete statement that
relies on the alternatives for completion.
- Following the stem is a list of alternatives or options for the learner to consider and
choose from.
- These alternatives are of two types:
o Answer, which is the correct or best response to answer the question or complete
the statement, and
o Distractors, which are the incorrect alternatives. The purpose of the distractors, as
the word implies, is to distract students who are unsure of the correct answer.
Advantages:
- These items are difficult to construct, particularly at the higher cognitive levels.
- Teachers often experience difficulty developing plausible distractors.
- If a distractor is not plausible, it provides an unintended clue to the test-taker that it is not
the correct response
- Multiple-choice items are time-consuming to construct.
- Cannot measure attitude or motor skills
- Elements of guess work is not completely eliminated
- Students require more time to answer to.
- The stem should present clearly and explicitly the problem to be solved.
- Although the stem should be clear and explicit, it should not contain extraneous
information unless the item is developed for the purpose of identifying significant versus
insignificant data.
- Avoid inserting information in the stem for instructional purposes.
- If words need to be repeated in each alternative to complete the statement, shift them to
the stem.
- Do not include key words in the stem that would clue the student to the correct answer.
- Avoid the use of negatively stated stems, including words such as “no,” “not,” and
“except.”
- The stem and alternatives that follow should be consistent grammatically.
- Avoid ending stems with “a” or “an” because these often provide grammatical clues as to
the option to select.
- If the stem is a statement completed by the alternatives, begin each alternative with a
lower-case letter and place a period after it because it forms a sentence with the stem.
- Each multiple-choice item should be independent of the others.
- Write the stem so that the alternatives are placed at the end of the incomplete statement
In these item formats, several alternatives may be correct, and students choose either all of the
correct alternatives (multiple-response) or the best combination of alternatives (combined-
response). Multiple-response items are included on the NCLEX examination as one type of item
format. Students select all of the options that apply by checking the box that precedes each
option.
The principles for writing multiple-response items are the same as for writing multiple-choice.
Additional suggestions for writing combined- response items include the following: