A skilled test-item writer carefully “engineers” construction of the stem of a question.
The construction has specific goals:
Firstly, the item writer must be confident that test-taker clearly understands what is being asked in the question.
Secondly, there must be sufficient information that leads the test-taker to the correct diagnosis or away from incorrect diagnoses.
Thirdly, when the question asks for the preferred therapy, there must be appropriate information, for example, renal function values, or a co-existing condition, for example, pregnancy, that leads the test-taker to the correct response.