A comparison is presented of alternate-choice and true-false item forms used in an undergraduate natural science course. The alternate-choice item is a modified two-choice multiple-choice item in which the two responses are included within the question stem. This study (1) compared the difficulty level, discrimination level, reliability, and criterion related validity of the alternate-choice item form and content equivalent true-false item form; (2) investigated if it is practical to judge whether the alternate-choice item version with the correct answer listed first or the version with the incorrect answer first is the better form of the item, and whether the true form of a true-false item or the false form is the better type of this item version; and (3) examined the effects of placing the correct answer first or the incorrect answer first on item difficulty, item discrimination, reliability, and criterion related validity of the item. The correct answer and best distractor of a multiple-choice item (from a 400 question item pool) were converted to an alternate choice format to produce two tests, a mid-term and a final exam. The alternate-choice item was found less difficult than the true-false item, replicating previous findings for this item type. However, findings concerning greater discrimination and higher reliability of the alternate-choice item were not replicated. (PN)