The congruence of learning outcomes and learning achievement test instrument need to be appropriate so that graduates are competent. To evaluate the process of developing learning outcome tests and content validity in the Diploma Program of Polytechnics Health Jakarta II. Survey, descriptive and cross sectional. Collecting data about the validation of learning outcome test questions is done by looking at how the lecturer develops the learning outcomes test and the quality of the test instrument. The development of learning outcomes test questions was carried out with a questionnaire on 40 lecturers randomly selected and content validity data obtained from the exam questions and semester learning plan one expertise courses from seven majors. The questionnaire for the development of learning outcomes was modified by Munadi, while content validation used Lawshe coefficient with a validator number of five people. Descriptive quantitative analysis. Development of 71 % learning test is a combination of essay and multiple–choice questions, 63 % of lecturers make question boxes, 33 % of lecturers always validate the problem with competency or learning achievement and only 22 % of lecturers adjust the questions with the indicators. The content validation ratio is 0.90 with a panel of five experts. The commitment of lecturers and institusions to maintain the quality of the learning outcomes test instrument that is integrated so that evidence based practice needs to be improved so that graduates quality is maintained.