How To Solve MCQs (True False)

Author: Dr. Muddasser Khurshid
This guideline can be used for the question papers having same format.

NOTE: This guideline was written for previous format of pmdc examination, now they have changed the format to CHOOSE ONE BEST ANSWER type of MCQs. However, you can go through this article and get an idea about MCQs.

The PMDC (Pakistan Medical and Dental Council) theoretical paper has True and False type of MCQs, it means every choice of an MCQ has to be marked True to False, and carries one score. If you marked any choice correctly, you will get ONE score, and if you marked it wrong, you will get 0.25 marks deducted from your score. For example, an MCQ having 5 choices and you mark 4 choices wrong you will get minus 1 score and the one choice you  marked correct will get you plus 1 score, and this equals to zero ‘0’ score for that MCQ.

One paper has 100 MCQs and each MCQ has 5 choices, having 500 marks total, with 1 score for correct answer and -0.25 score for wrong answer. The passing score is 50% of total in this part. It means that you can make maximum 200 wrong answers, and you must have to have at least 300 correct answers to get you passing score. According to this statistics, you can have 2 wrong answers per MCQ, that will be fine. Then each MCQ will be carrying 2.5 marks (3 marks for 3 correct answers minus 0.5 marks for 2 wrong answers).

In order to get most of correct answers, you should understand what the question really means, because sometimes the MCQs are really tricky, and difficult to understand. So, understanding question really helps you in solving it.

There are different types of MCQs according to number of true and false choices, including

  • has a single true choice and others false (occurs very less)
  • has mixed probability of true and false choices (occurs frequently)

If an MCQ asks like “which is the cause of …. ” then there will be only one true choice and others are false. If you are not sure which choice is true, mark all statements false. This will give you 3.75 marks for that MCQ (4 marks for 4 correct answers and -0.25 mark for 1 wrong answer). If you try to guess the true choice, and your guess goes wrong, then you will get 2.5 marks (3 marks for 3 correct answers and -0.5 marks for 2 wrong answers). So, if you are not sure for your guess, try to get maximum marks by making all choice false.

If an MCQ asks like ” which are the causes of ….” then there will be mixed probability of true and false choices. This kind of MCQ is a bit difficult to solve. If you don’t know which choice is true and which is false, try to apply logic to every choice, and try to think that if this really happens or works. Remember you can do any kind of question if you think logically over it.

For example, in following MCQ, assume that you don’t know the true choices, try to think this way :

The following statements concerning fluid and electrolyte balance are correct:

a. Nasogastric aspirates should be replaced volume for volume with 5% dextrose solution.

Explanation: Nasogastric aspirate doesn’t include only dextrose/glucose, so that it should be replaced, but it also contains electrolytes and other nutrients. So, if it has to be replaced, it should be replaced with electrolyte solution.  So, this is FALSE.

b. 100 mmol potassium are required each day to replace baseline losses.

Explanation: There isn’t any fixed amount of potassium loss on daily basis, rather it depends on activity and physiological state. So, this statement should be FALSE.

c. Long-standing fluid deficits should be replaced within the first 24 hours.

Explanation: If the fluids are replaced in first 24 hrs, it may cause fluid overload comparing to the current physiological state, so this seems to be FALSE.

d. Insensible losses are unchanged by fever.

Explanation: As water evaporation is affected by rise in temperature and it increases, so is the case with insensible losses in fever, and they increase with the rise in body temperature, This statement is FALSE.

e. A total daily intravenous fluid intake of 1500 ml will maintain baseline fluid requirements in a normal individual.

Explanation: Fluid requirements vary with the activity and temperature of environment, so there isn’t any fixed amount of fluids is required, rather it varies. So, this statement is FALSE.

In the above example, all statements are false, it means that all statements can be false or true in a single MCQ. So, think to the best of your knowledge and concepts, if you really don’t know the answers.


When faced with an MCQ that you are unsure about, a number of points can help you make an educated guess.

Key words

An understanding and familiarity with the key words and phrases that commonly feature in MCQs is vital to maximising your score (table). Questions which include absolute and sweeping statements such as never, always, or exclusively are generally false (because exceptions can be found to virtually any rule). Questions which include the keywords could, possible, or may are more often true than not (after all, anything is possible).

Statistical statements

When a question states an exact statistic–for example, the five year mortality after a first myocardial infarction is 12.9% it is often false (as different studies will produce different figures). This general rule does not apply to less precise statistics–the five year mortality after a first myocardial infarct is greater than 5%.

Unfamiliar information

If you encounter a question on a topic which you believe you have a good knowledge of, but the information stated is completely unfamiliar to you, then the chances are that it is false. (For example, if having revised myocardial infarcts you find an MCQ stating Colanss syndrome is a frequent sequelae of myocardial infarction you should answer false as you will not have heard of Colanss syndrome before.)


MCQs are often perceived as being inordinately difficult. But with a planned approach to revision, incorporating a general overview of the syllabus, and careful attention to technique, many questions can be confidently answered correctly and further marks gained by making educated guesses.

Pakistani Foreign Medical Students and Graduates