Researchers frequently use Mokken scale analysis (MSA), which is a nonparametric approach to item response theory, when they have relatively small samples of examinees. Researchers have provided some guidance regarding the minimum sample size for applications of MSA under various conditions. However, these studies have not focused on item-level measurement problems, such as violations of monotonicity or invariant item ordering (IIO). Moreover, these studies have focused on problems that occur for a complete sample of examinees. The current study uses a simulation study to consider the sensitivity of MSA item analysis procedures to problematic item characteristics that occur within limited ranges of the latent variable. Results generally support the use of MSA with small samples (N around 100 examinees) as long as multiple indicators of item quality are considered.