Define the learning objective
Choose one clear concept or fact per question
Write a direct and unambiguous stem
Include only necessary information in the stem
Make the correct answer clearly correct
Create plausible distractors
Keep all options similar in length and style
Avoid clues in grammar, wording, or formatting
Use one best answer format when possible
Avoid negative phrasing unless essential
If using negatives, emphasize them clearly
Ensure only one option is fully correct
Randomize the position of the correct answer
Avoid “all of the above” and “none of the above” when possible
Keep the language simple and precise
Match the difficulty to the target audience
Check for ambiguity and multiple interpretations
Verify factual accuracy
Avoid trick questions
Review for bias and cultural unfairness
Test the question for clarity and reliability
Edit for grammar, spelling, and consistency