Item analysis is a method for assessing an exam's effectiveness by looking at each of its individual parts or items. It is a procedure of assessing the worth of the test's individual elements and the test as a whole based on student responses to particular test items. It can be utilised to identify elements that are murky or deceptive within a single administration. Additionally, item analysis can be used to pinpoint specific course material passages that need to be emphasised or clarified. A critical stage in the process of standardising summative tests is item analysis. The complexity and internal coherence of the true or false and multiple-choice questions that the instructor produced for the midterm tests given to graduating students of the third year B Sc Nursing at Sikkim Manipal College of Nursing are examined in this study.