A TriagePass question tests one decision in a clinical vignette, has one defensible best answer, uses options of similar length and plausibility, and carries an explanation that names its source. Passing should require having studied, not guessing from the wording.
Principles
- Test what the exam tests. Every question maps to one domain in the exam blueprint, at the depth the exam expects.
- One decision per question. The stem sets up a situation. The options are possible actions or conclusions. The candidate chooses the best one.
- One best answer. If two options could both be defended by a reasonable clinician following the national guideline, the question is rewritten.
- No tricks. We do not test your reading of a double negative or a buried detail. We test judgement.
- Explain, then cite. Every explanation says why the answer is right, why each distractor is wrong and which guideline or standard supports it.
Stems
A stem is a short vignette: who the patient or situation is, what has happened, what is known. It contains what is needed to decide and little else. Age, sex, setting, key findings and relevant results appear when they change the answer. Units and reference ranges match the exam's country, so a UK question uses mmol/L and a US question uses mg/dL when that is how the exam reports them.
The lead-in is a clear question: "What is the most appropriate next step?", "Which drug should be started?", "What should the nurse do first?" It does not hide the task in the middle of the vignette.
Options
- Options are similar in length, grammar and level of detail, so the correct one cannot be spotted by shape.
- Every distractor is plausible: a real management step, a real drug, a common mistaken belief.
- No "all of the above" or "none of the above". Options are in a logical order, such as alphabetical or numerical.
- The position of the correct answer is randomised.
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Matching the exam's style
Item styles differ by exam. PLAB 1 uses single best answer with five options. The NMC CBT mixes numeracy and clinical items. NCLEX-RN includes next-generation case studies and multi-response formats. We build each bank in the style of its exam, and our mocks use the exam's real count and time limit. Where an exam body publishes no format, we say that on the exam page.
Content standards
- Current guidance. Answers follow the national guideline in force for the exam's country, and the version is recorded.
- Drug doses and thresholds. Doses, cut-offs and ranges are checked against the formulary or guideline, not against another question.
- Law and ethics. Questions on professional conduct use the regulator's own standards for that exam.
- Originality. Questions are written for TriagePass. We do not use recalls, past papers or other banks.
- Inclusive, accurate scenarios. Patients are described without stereotypes, and clinical relevance is the only reason to mention a patient's characteristics.
Checks every question passes
| Check | Question asked |
|---|---|
| Blueprint | Does it map to one domain and the right depth? |
| Single best answer | Can a clinician following the guideline defend only one option? |
| Distractors | Is each wrong option plausible and clearly wrong for a stated reason? |
| Guideline | Does the answer match the current national source, and is it recorded? |
| Wording | Is it free of cues, double negatives and unnecessary detail? |
| Explanation | Does it teach the reasoning and name the source? |
| Clinician review | Has a clinician in the profession approved it? |
After publication
We watch how each question performs. A question that nearly everyone gets right, or one that strong candidates get wrong more often than weak ones, is flagged for review. Error reports from users take priority. The process is described in the editorial policy.
Frequently asked questions
Why are all answer options a similar length?
So the correct answer cannot be spotted by its shape. If the longest or most detailed option is usually right, the question tests test-taking skill rather than knowledge.
Do you write questions in the style of each exam?
Yes. Each bank follows its exam's item format, count and timing where these are published.
What if a question has two defensible answers?
It is rewritten or withdrawn. Every question must have one best answer under the national guideline in force.
Do your explanations cite sources?
Yes. Each explanation names the guideline or standard behind the answer and the reasoning for each wrong option.
How are poorly performing questions found?
We track how each question performs. Questions that almost everyone answers correctly, or that strong candidates miss more than weak ones, are reviewed.
Last reviewed October 2026