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The purpose of this study was to assess multiple-choice questions used in test-banks accompanying selected nursing textbooks. A random sample of 2,913 questions was selected from a convenience sample of 17 test banks. Questions were evaluated on (a) adherence to generally accepted guidelines for writing multiple-choice questions; (b) cognitive level as defined by Bloom's (1961) taxonomy; and (c) distribution of correct answers as A, B, C, or D. The results were 2,233 violations of item-writing guidelines, most of which were minor but some were serious. A large number of questions (47.3%) were written at the knowledge level and only 6.5% were written at the analysis level. The correct answers were evenly distributed: c2s ranged from 0.00 to 4.84; chi square value needed to reach .05 probability was 26.30. Faculty are encouraged to evaluate multiple-choice questions from test banks carefully before using them for exams.
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