An alternate item format is an exam item, or question, that uses a format other than the standard, four-option format of a multiple-choice item to assess a candidate's ability. Alternate item formats may include:
- Multiple response items that require a candidate, regardless of the number of options, to select a single response, multiple responses, or all responses as correct to answer the item
- Fill-in-the-blank items that are calculation based and require a candidate to answer using numbers
- Chart/exhibit items where candidates are presented with a problem and need to review the information in the chart/exhibit to select an answer
- Ordered response items that require a candidate to move and place options in the correct sequence or order
- Graphic items that present the candidate with images either as part of the stem or as options
Any item formats, including standard multiple-choice items, may include charts, tables or graphic images.
Examples of each alternate item format can be found in the NCLEX Tutorial, offered in both English and French.