🎯 Next Gen Item Types · Lesson 1 of 5 · 6 min

SATA: Every Option Is Its Own True-or-False Question

☑️ Six options, 'select all that apply', and a creeping suspicion that picking three is somehow the norm. There is no norm. There is a scoring rule, and once you know it, the panic goes away.

💡 Key idea

Read each option as its own true-or-false statement for this client. Plus/minus scoring punishes guesses, so select only what you can defend.

🧠 Why it matters

In a SELECT ALL THAT APPLY item, any number of options can be correct, from one to all of them. Treat each option as an independent TRUE or FALSE statement about the situation in the stem; never count how many you have chosen. Select-all items use PLUS/MINUS scoring: each correct selection earns a point and each incorrect selection subtracts one, with the item score never falling below zero, so a reckless extra click can cancel a correct one. Items that name how many to choose use ZERO/ONE scoring instead: each correct choice earns a point, and a wrong choice earns nothing but subtracts nothing. Either way, the question to ask for each option is 'Is this true for THIS client right now?' Watch for options that are correct in general but wrong for the stem's client (a normal finding in the wrong age group, an intervention contraindicated by the history). Some items say 'select N' and tell you exactly how many to choose; then choose exactly that many.

🏥 In the real world

🧾 Stem: a client with heart failure on furosemide. 'Which findings require follow-up? Select all that apply.' Options: weight gain of 3 pounds overnight (true), potassium 2.9 (true), heart rate 72 (false), bilateral crackles (true), urine output 60 mL/hr (false), reports of muscle cramps (true: hypokalemia). Four true, two false, decided one at a time. The number four was never the goal; it was the result.

📌 Takeaways

Any number of options can be correct
Each option is true or false for the client in the stem
Extra guesses can subtract points; choose what you can defend

📖 Terms in this lesson

Select all that apply (SATA): An item where any number of options can be correct, so each option is judged on its own as true or false.

✅ Test yourself

What is the best approach to a 'select all that apply' item?

Select the options that sound most medical
Select every option, since partial credit is given
Judge each option as true or false on its own
Always select at least three options

Answer: C · Judge each option as true or false on its own

Evaluating each option as a separate true-or-false statement about the client in the stem prevents both under- and over-selection; selecting everything loses points under plus/minus scoring.

Under plus/minus scoring, what happens when a candidate selects an incorrect option on a select-all item?

Nothing; only correct selections count
The entire item is scored zero
The candidate must restart the item
One point is subtracted from the item score

Answer: D · One point is subtracted from the item score

Incorrect selections cancel correct ones, which is why careless extra selections hurt; the item score cannot fall below zero.

An item reads 'Select the 3 findings that require immediate follow-up.' How many should the candidate select?

At least 3
Exactly 3
No more than 2
As many as seem relevant

Answer: B · Exactly 3

'Select N' items specify the number; choose exactly that many.

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