Multiple-choice questions are an important part of large-scale summative assessments, such as the advanced placement (AP) chemistry exam. However, past AP chemistry exam items often lacked the ability to test conceptual understanding and higher-order cognitive skills. The redesigned AP chemistry exam shows a distinctive shift in item types toward the assessment of these more advanced learning outcomes. This article describes the attributes of multiple-choice questions that assess these skills and thus coincide with the AP chemistry curriculum framework. Also, methods for updating existing questions to conform to these goals are described. From this, teachers of AP chemistry may adapt their current assessments to more accurately measure these desired learning objectives and skills.