Negative questions (multiple choice questions)

Negative questions, also known as odd-one-out questions are a type of multiple choice question in which the correct answer is the one that is false, surrounded by true distractors. For example: 

Question: Which of the following statements regarding an alveolar lung pattern on a canine thoracic radiograph is INCORRECT

• Alveolar patterns are frequently characterized by air bronchograms

• Alveolar filling can be caused by fluid, exudate, cells, or blood

• Alveolar opacities always shift to the non-dependent lung field with changes in patient positioning ← correct answer

• Alveolar patterns can obscure the normal pulmonary vascular margins

For the purposes of examination, these types of question are generally frowned upon for two reasons: 

1. it is possible for examinees to misread the question and attempt to identify the most correct rather than false alternative

2. it is hard to prove a falsehood

Although both of these criticisms are valid, particularly in the exam setting, there are many situations in which this format is desirable. For example: 

Question: Which of the following histologic subtypes of canine osteosarcoma is the LEAST common?

• osteoblastic

• chondroblastic

• fibroblastic

• telangiectatic ← correct answer (least common)

Best practices

Before writing a negative question, ask yourself the following questions:

• can this be rephrased as a positive question?

• is the fact that one of the options is incorrect/false explicitly supported by the related articles? 

Style

In all of these questions, to minimize the risk of misreading, make sure the negative word is in ALL CAPS and emboldened. For example

• Which is the LEAST common...

• The following are features EXCEPT... 

• Which of the following is INCORRECT?