The book provides guidance and direction for any nurse educator teaching in the professional environment and must write questions to evaluate learning. It covers the basics of item writing and leveling of items using Bloom's taxonomy to the learner. In addition, the book provides stem examples and new types of questions expected on the National Council Licensure Examination for both the registered and practical nurse. Finally, case study development and item analysis are presented. Evaluation of student performance by examination is critical in nursing education, from undergraduate to continuing education programs. Many faculty have reported learning the item writing process in graduate programs, but it is often lost or not reused. Recent research reports nursing faculty using textbook questions that have not been validated and security of the questions have been compromised. A nursing education profession should have the ability to develop items to validate that learning has occurred. The skill is essential to any professional to evaluate the effectiveness of learning. Critical thinking is a skill necessary for licensure examinations, and students often need assistance to learn this skill to pass the licensure examination and practice as a nurse. Therefore, faculty need a source to facilitate their development of the learned item writing process to assist learners and prepare them for practice. This book is unique in that it addresses the basics and the advanced components. In addition, the book provides a substantial list of stems and case study ideas. Finally, the book describes how to use a knowledge-based item and develop an item to a higher level of Blooms' taxonomy and assists those nursing programs that educate international students to adequately prepare for the student to pass the national licensing examination required to practice in the US and Canada.