Multiple choice tests are widely viewed as the most effective and objective means of assessment. Item development is the central component of creating an effective test, but test developers often do not have the background in item development. This document describes recall, application, and analysis, the three cognitive levels of test items. It also reviews single best response, situational set, and complex, the three main item types. A discussion is provided of guidelines for writing appropriate and effective item stems, keyed responses, and distracters. (Contains 11 references.) (JDM)