Most large-scale testing programs facing computerized adaptive testing (CAT) must face the challenge of maintaining extensive content requirements, but content constraints in computerized adaptive testing (CAT) can compromise the precision and efficiency that could be achieved by a pure maximum information adaptive testing algorithm. This simulation study first evaluated whether realistic content constraints could be met by carefully assembling testlets and appropriately selecting testlets for each test taker that, when combined, would meet the content requirements of the test and would be adapted to the test takers ability level. The second focus of the study was to compare the precision of the content-balanced testlet design with that achieved by the current paper-and-pencil version of the test through data simulation. The results reveal that constraints to control for item exposure, testlet overlap, and efficient pool utilization need to be incorporated into the testlet assembly algorithm. More refinement of the statistical constraints for testlet assembly is also necessary. However, even for this preliminary attempt at assembling content-balanced testlets, the two-stage computerized test simulated with these testlets performed quite well. (Contains 5 figures, 5 tables, and 12 references.) (Author/SLD)