Background: Of the myriad of reading comprehension (RC) assessments used in schools, multiple-choice (MC) questions continue to be one of the most prevalent formats used by educators and researchers. Outcomes from RC assessments dictate many critical factors encountered during a student's academic career, and it is crucial that we gain a deeper understanding of the nuances of these assessments and the types of skills needed for their successful completion. The purpose of this exploratory study was to examine how different component skills (i.e., decoding, word recognition, reading fluency, RC and working memory) were related to students' response accuracy as they read a text and responded to MC questions. Methods: We monitored the eye movements of 73 third graders as they read an expository text and answered MC questions. We investigated whether the component skills differentially predicted accuracy across different question types and difficulty levels. Results: Results indicated that readers who answered MC questions correctly were able to identify when they needed to reread the text to find the answer and were better able to find the relevant area in the text compared with incorrect responders. Incorrect responders were less likely to reread the text to find the answer and generally had poorer precision when attempting to locate the answer in the text. Finally, the component skills relied upon by readers to answer RC questions were related to the type and difficulty of the questions. Conclusions: Results of the present study suggest that comprehension difficulties can arise from a myriad of sources and that reading abilities together with test-taking strategies impact RC test outcomes.