TEAS 7 English and Language Usage: grammar rules, timing and practice
The TEAS 7 English and Language Usage section has 37 questions in 37 minutes, about one minute each, and it comes last. 33 questions are scored: Conventions of Standard English (12), Knowledge of Language (11) and Using Language and Vocabulary to Express Ideas in Writing (10). The questions reward rules you can learn: sentences, punctuation, agreement, spelling and word parts.
English at a glance
37 questions in 37 minutes, about 60 seconds per question.
33 scored and 4 unscored pretest questions; you cannot tell which are unscored.
English and Language Usage is always the last section, after Reading, Math, the optional 10-minute break and Science.
Unused time does not carry over; unanswered questions count as incorrect; there is no penalty for guessing.
What is on the TEAS English section?
Conventions of Standard English: 12 scored questions (objectives E.1.1, E.1.2, E.1.3).
Knowledge of Language: 11 scored questions (objectives E.2.1, E.2.2, E.2.3).
Using Language and Vocabulary to Express Ideas in Writing: 10 scored questions (objectives E.3.1, E.3.2).
What does each English objective ask?
E.1.1 Spelling: Choose the correctly spelled word for the context, including homophones such as their, there and they're. Taught in chapter 8.
E.1.2 Punctuation: Punctuate a sentence by its clauses and meaning: commas, semicolons, colons, apostrophes and quotation marks. Taught in chapter 8.
E.1.3 Sentence structure: Recognize simple, compound, complex and compound-complex sentences, and repair fragments, run-ons and comma splices. Taught in chapter 6.
E.2.1 Clarity through grammar: Fix subject-verb and pronoun agreement, unclear pronouns, verb tense, parallel structure and misplaced modifiers. Taught in chapter 7.
E.2.2 Audience/context: Choose wording and detail that fit the stated audience and purpose, formal or informal. Taught in chapter 7.
E.2.3 Paragraphs: Order sentences into a coherent paragraph and choose the topic sentence or transition that fits. Taught in chapter 9.
E.3.1 Writing process: Choose the right planning, drafting, revising or editing step for a writing problem. Taught in chapter 9.
E.3.2 Word parts: Use prefixes, roots and suffixes, checked against context, to work out a word's meaning. Taught in chapter 3.
How do I manage 37 questions in 37 minutes?
Plan on one question a minute: question 10 by 10:00, question 20 by 20:00 and question 30 by 30:00.
Rule questions (a comma, an apostrophe, a verb form) can take 20 to 40 seconds once the rules are automatic. That banks time for paragraph and revision questions, which take longer to read.
English comes after about three hours of Reading, Math, the optional break and Science. Practise full-length timed sets at least once so the last section does not feel like the hardest.
Flag any question that passes about 90 seconds, choose your best answer and move on. Unanswered questions count as incorrect, and there is no guessing penalty.
Question 10 done by 10:00 elapsed (27:00 left).
Question 20 done by 20:00 elapsed (17:00 left).
Question 30 done by 30:00 elapsed (7:00 left).
Question 37 done by 37:00 elapsed (0:00 left).
Sentence types
Simple: One independent clause. It may have a compound subject or verb and extra phrases, but only one subject-verb core. Example: The clinic opens at eight.
Compound: Two or more independent clauses, joined by a comma plus a coordinating conjunction (FANBOYS) or by a semicolon. Example: The clinic opens at eight, and the lab opens at nine.
Complex: One independent clause plus at least one dependent clause, which starts with a subordinator (because, when, although) or a relative pronoun (who, which, that). Example: When the clinic opens, the phones start ringing.
Compound-complex: Two or more independent clauses plus at least one dependent clause. Example: When the clinic opens, the phones start ringing, and the front desk gets busy.
Coordinating conjunctions (FANBOYS)
The seven coordinating conjunctions are for, and, nor, but, or, yet and so. Put a comma before one when it joins two independent clauses. Example: The test was long, but she finished on time.
No comma when the conjunction joins two verbs that share one subject. Example: She studied every evening and passed the quiz.
Subordinators and dependent clauses
Subordinators include because, although, though, since, unless, if, when, while, after, before, until, once and whereas. A clause that starts with one is dependent: it cannot stand alone. Example: Because the road was icy (fragment on its own)
Dependent clause first: put a comma after it. Example: Because the road was icy, the bus ran late.
Main clause first: usually no comma before because, when, if or after. Contrast words such as although and whereas often take one. Example: The bus ran late because the road was icy.
Relative pronouns (who, whom, whose, which, that) also start dependent clauses. Example: The aide who trained me starts at six.
Commas
Separate three or more items in a series. Many style guides keep the comma before "and" (the serial comma); be consistent. Example: The kit holds gauze, tape, and scissors.
Put a comma after an introductory word, phrase or clause. Example: After the break, the Science section begins.
Set off extra (nonessential) information with commas. Information needed to identify the noun takes no commas. Example: My sister, who is a nurse, works nights. / The nurse who works nights is my sister.
Never put a single comma between a subject and its verb. Example: Wrong: The patient in room four, needs water. Right: The patient in room four needs water.
Semicolons and colons
A semicolon joins two closely related independent clauses without a conjunction. Example: The lab is closed; the results will arrive tomorrow.
Use a semicolon before a transition word such as however, therefore or as a result, and a comma after it. Example: The clinic was busy; however, the wait was short.
Use semicolons between list items that already contain commas. Example: The tour stops in Austin, Texas; Tulsa, Oklahoma; and Denver, Colorado.
A colon follows a complete sentence and introduces a list, an explanation or an example. Example: The recipe needs three things: flour, eggs, and milk.
Do not put a colon after "include", "such as" or a verb. Example: Wrong: The kit includes: gauze and tape. Right: The kit includes gauze and tape.
Apostrophes
Singular possessive: add 's. Example: the nurse's badge
Plural possessive ending in s: add only the apostrophe. Example: the nurses' lounge
Irregular plural possessive: add 's. Example: the children's ward
It's means "it is" or "it has"; its means "belonging to it". Example: It's late, and the clinic has locked its doors.
Never use an apostrophe to make a plain plural. Example: two doctors (not two doctor's)
Subject-verb agreement
Find the subject and ignore prepositional phrases between it and the verb. Example: The box of gloves is empty.
Two subjects joined by "and" take a plural verb. Example: The nurse and the aide are on break.
With "or" or "nor", the verb agrees with the nearer subject. Example: Neither the doctors nor the nurse is available.
Each, every, everyone, either and neither are singular. Example: Each of the patients has a chart.
In "there is" and "there are", the subject comes after the verb. Example: There are two forms to sign.
Pronouns
A pronoun agrees in number with the noun it replaces. Example: The clinic updated its website.
Every pronoun needs one clear antecedent. Example: Unclear: When Maria called Dana, she was upset. Clear: Maria was upset when she called Dana.
Use subject forms (I, he, she, we, they, who) as subjects and object forms (me, him, her, us, them, whom) after verbs and prepositions. Example: She and I studied together. / The tutor helped her and me.
Use who for people and which for things; that can refer to either in an essential clause. Example: The student who asked was right. The chart, which was new, was easy to read.
Parts of speech
Noun: a person, place, thing or idea. Pronoun: replaces a noun. Example: The nurse (noun) said she (pronoun) would return.
Verb: an action or state. Adjective: describes a noun. Adverb: describes a verb, adjective or another adverb. Example: The tired (adjective) aide walked (verb) slowly (adverb).
Preposition: shows a relationship such as place or time. Conjunction: joins words or clauses. Interjection: shows sudden feeling. Example: Oh (interjection), the chart is on (preposition) the desk, and (conjunction) the pen is beside it.
Spelling and plural rules
Write i before e except after c, or when the sound is "ay". Learn the exceptions as a list. Example: believe, receive, neighbor; exceptions: weird, seize, either
Drop a silent final e before a suffix that starts with a vowel; keep it before a consonant. Example: hope → hoping, but hope → hopeful
Change a final y to i before a suffix, unless a vowel comes before the y or the suffix is -ing. Example: happy → happiness; play → played; cry → crying
Double the final consonant of a one-syllable word (or a stressed final syllable) that ends consonant-vowel-consonant before a vowel suffix. Example: stop → stopping; begin → beginning; but open → opening
Add -es to nouns ending in s, x, z, ch or sh; change consonant + y to -ies. Example: box → boxes; clinic → clinics; city → cities; day → days
Some f or fe endings become -ves; some plurals are irregular. Example: knife → knives; roof → roofs; child → children; analysis → analyses
Commonly confused words
affect / effect: Affect is usually a verb (to influence); effect is usually a noun (a result). Example: Caffeine can affect sleep; the effect lasts hours.
accept / except: Accept means to receive or agree; except means "other than". Example: We accept all cards except store cards.
its / it's: Its shows possession; it's means "it is" or "it has". Example: It's time to check its battery.
their / there / they're: Their shows possession; there is a place; they're means "they are". Example: They're leaving their bags over there.
your / you're: Your shows possession; you're means "you are". Example: You're next, so bring your form.
than / then: Than compares; then shows time or order. Example: Rest first, then study for longer than an hour.
to / too / two: To is a preposition; too means "also" or "excessively"; two is the number. Example: The two of us went to class, and Ana came too.
lose / loose: Lose means to misplace or fail to win; loose means not tight. Example: Do not lose the loose button.
principal / principle: Principal is a head of a school or the main one; principle is a rule or belief. Example: The principal explained the principle of fairness.
whose / who's: Whose shows possession; who's means "who is" or "who has". Example: Who's the student whose badge this is?
Word parts for vocabulary
anti- (prefix): against, as in antibacterial.
brady- (prefix): slow, as in bradycardia (slow heart rate).
tachy- (prefix): fast, as in tachycardia (fast heart rate).
hyper- (prefix): above, excessive, as in hypertension.
hypo- (prefix): below, deficient, as in hypoglycemia.
inter- (prefix): between, as in intercostal (between the ribs).
intra- (prefix): within, as in intravenous.
peri- (prefix): around, as in pericardium.
post- (prefix): after, as in postoperative.
pre- (prefix): before, as in prenatal.
sub- (prefix): under, as in subcutaneous.
dys- (prefix): difficult, abnormal, as in dysphagia (difficulty swallowing).
cardi (root): heart, as in cardiology.
derm (root): skin, as in dermatitis.
gastr (root): stomach, as in gastric.
hem, hemat (root): blood, as in hematology.
hepat (root): liver, as in hepatitis.
neur (root): nerve, as in neuron.
oste (root): bone, as in osteoporosis.
nephr, ren (root): kidney, as in nephron, renal.
-itis (suffix): inflammation, as in arthritis.
-ectomy (suffix): surgical removal, as in appendectomy.
-ology (suffix): study of, as in biology.
-algia (suffix): pain, as in neuralgia.
-emia (suffix): blood condition, as in anemia.
-less (suffix): without, as in painless.
Is the English section of the TEAS hard?
Themes from public forum posts and reviews read in October 2026. These are reports, not statistics.
Many test-takers, including native English speakers, describe English as their hardest or lowest section. The trouble is usually terminology: simple, compound and complex sentences, punctuation, parts of speech, prefixes and suffixes, and spelling rules.
Some say they underestimated English and left it until last. Learning the names of the rules, not just what sounds right, targets the terminology that trips people up.
Free TEAS English practice questions
Eight original questions written to the TEAS 7 English objectives, with explanations. They are not real TEAS items.
1. (E.1.3) Which of the following is a complex sentence? A) The nurse checked the chart, and the doctor reviewed the scan. B) Because the lab closed early, the samples were sent to another site. C) The samples arrived late and were tested the next morning. D) The lab closed early, so the samples went elsewhere, and the report was delayed. Answer: B. A complex sentence has one independent clause and at least one dependent clause. "Because the lab closed early" cannot stand alone, so B is complex. A joins two independent clauses (compound), and D joins three. C is simple: one subject with a compound verb.
2. (E.1.3) Which revision correctly fixes the comma splice? The appointment ran late, the patient missed her bus. A) The appointment ran late, the patient, missed her bus. B) The appointment ran late; the patient missed her bus. C) The appointment ran late, however the patient missed her bus. D) The appointment ran late the patient missed her bus. Answer: B. A semicolon can join two related independent clauses. A is still a comma splice and adds a comma between the subject and its verb. C is still a splice: "however" is a transition word that needs a semicolon before it, and it signals a contrast that does not fit. D removes the comma and creates a run-on.
3. (E.1.2) Which sentence uses apostrophes correctly? A) The two nurses' break room was repainted last week. B) The clinic changed it's hours for the holiday. C) Both doctor's offices are on the second floor. D) The patients's files were updated. Answer: A. For a plural noun ending in s, the apostrophe goes after the s: nurses'. In B, it's means "it is", so the possessive should be its. C needs doctors' because there are two doctors. D should be patients' (plural) or patient's (singular), never patients's.
4. (E.2.1) Which verb correctly completes the sentence? The list of supplies for the new clinic ___ on the counter. A) is B) are C) were D) have been Answer: A. The subject is "list", which is singular. "Of supplies for the new clinic" is a prepositional phrase, so ignore it when you match the verb. B, C and D are plural forms that agree with "supplies" by mistake.
5. (E.2.1) Which sentence is written most clearly? A) Walking into the clinic, the smell of disinfectant greeted Ana. B) Walking into the clinic, Ana noticed the smell of disinfectant. C) Ana noticed the smell of disinfectant walking into the clinic. D) The smell of disinfectant, walking into the clinic, greeted Ana. Answer: B. An opening phrase describes the noun right after the comma. In B, Ana is the one walking. In A and D the smell seems to be walking (a dangling modifier). In C, "walking into the clinic" sits next to "disinfectant", so it reads as if the disinfectant is walking.
6. (E.3.2) Using word parts, what does "hyperglycemia" most likely mean? A) low blood sugar B) high blood sugar C) inflammation of the blood D) sugar in the urine Answer: B. Hyper- means above normal, glyc refers to sugar, and -emia means a condition of the blood: high blood sugar. Low blood sugar (A) would be hypoglycemia. Inflammation (C) would use -itis, and urine (D) would use a part such as -uria.
7. (E.1.1) Which word is spelled correctly? A) recieve B) neccessary C) privilege D) seperate Answer: C. Privilege is correct. The others should be receive (e before i after c), necessary (one c, two s) and separate (s-e-p-a-r-a-t-e).
8. (E.2.2) A student is emailing a nursing program director to ask about the application deadline. Which sentence is most appropriate for this audience? A) Hey, when's the deadline? Thx! B) I am writing to ask when applications for the fall cohort are due. C) Deadlines stress me out, so tell me ASAP. D) I need to know some stuff about the deadline. Answer: B. A program director is a professional audience, so the message should be polite, formal and specific. B is all three. A and C are too casual, and C makes a demand. D is vague: "some stuff" does not say what the student needs.
Many test-takers, including native speakers, say English was harder than they expected, mainly because questions use grammar terms such as compound sentence, dependent clause or suffix. The section is short and rule-based, so learning the rules and their names, then practising with explanations, is a reliable way to improve.
How do I manage 37 questions in 37 minutes?
Plan on one question a minute and check your progress at questions 10, 20 and 30. Answer quick rule questions in well under a minute to bank time for longer paragraph and revision items. Flag anything that passes about 90 seconds, and answer every question, because there is no guessing penalty.
Which grammar rules are tested on the TEAS?
The English objectives cover spelling, punctuation, sentence structure (fragments, run-ons, comma splices and the four sentence types), agreement, pronoun reference, verb tense, parallelism and modifiers, writing for an audience, paragraph organization, the writing process and word parts. The quick reference on this page covers each one with an example.
What spelling, punctuation and plural rules do I need?
Know the common spelling patterns (i before e, dropping a silent e, changing y to i, doubling a final consonant), regular and irregular plurals, commonly confused words, comma and semicolon rules, colon use and apostrophes for possession and contractions. Learn the rule and a model sentence for each.
Can you fail one section of the TEAS and still pass?
ATI does not set a passing score for the test or for any section. Each program sets its own requirements: some look only at the total score, others also set minimums for sections such as English or Science. Check your program's published rules. ATI gives no total score unless all four sections are completed.
Is there a TEAS English rules PDF?
This page works as a printable rules sheet: use your browser's print command, and the page prints without navigation. The TEASPATH book teaches the same rules in chapters 3 and 6 to 9, with practice questions and explanations.
Do I need to memorize vocabulary lists for the TEAS?
Not long lists. The English section tests word parts (E.3.2): using prefixes, roots and suffixes, checked against context, to work out a meaning. Reading also tests words in context (R.2.2). Learning common medical and academic word parts is more useful than memorizing definitions.
TEASPATH is independent of ATI. ATI TEAS® and TEAS® are registered trademarks of Assessment Technologies Institute, L.L.C., which is not affiliated with and does not endorse TEASPATH. Practice results and estimates are not official scores or admission predictions. Sample questions and passages are original practice material, not real TEAS items.