TEAS Spelling, Punctuation, and Writing Conventions: The Complete Review

The English and Language Usage section of the TEAS tests your command of standard written English, including spelling, punctuation, grammar, sentence structure, and contextual vocabulary. With 37 questions in just 37 minutes, you need to move quickly and confidently. This guide covers the specific conventions and rules the TEAS targets most frequently so you can study efficiently and avoid careless errors.

Spelling Rules That Appear on the TEAS

Spelling questions on the TEAS usually present four options and ask you to identify the correctly spelled word, or they embed a misspelled word in a sentence and ask you to spot it. These questions test common English spelling patterns rather than obscure vocabulary. Knowing the rules behind the patterns is far more effective than memorizing word lists.

The i Before e Rule (and Its Exceptions)

The classic rule is "i before e, except after c, or when sounded like 'ay' as in neighbor and weigh." This gives you words like believe, achieve, receive, ceiling. However, there are notable exceptions that the TEAS likes to test: weird, seize, neither, foreign, height, protein, and caffeine. Memorize these exceptions specifically because they appear frequently on nursing entrance exams.

Dropping or Keeping the Silent e

When adding a suffix that begins with a vowel (-ing, -able, -ous, -ation), drop the silent e: hope → hoping, make → making, advise → advisable. When adding a suffix that begins with a consonant (-ment, -ful, -ness, -ly), keep the e: hope → hopeful, care → careful, state → statement. Key exceptions to remember: truly (not truely), argument (not arguement), judgment (not judgement in American English), and noticeable (keeps the e to preserve the soft c sound).

Doubling the Final Consonant

Double the final consonant before a vowel suffix when the word is one syllable and ends in a single consonant preceded by a single vowel: run → running, stop → stopped, plan → planned. For multi-syllable words, double only if the final syllable is stressed: begin → beginning, occur → occurring, refer → referring. Don't double when the stress is on the first syllable: open → opening, listen → listening, benefit → benefited.

Changing y to i

When a word ends in a consonant + y, change the y to i before adding a suffix (unless the suffix starts with i): study → studied, happy → happiness, carry → carries. Keep the y if the suffix starts with i: study → studying, carry → carrying. Also keep the y if it's preceded by a vowel: play → played, enjoy → enjoyable, delay → delayed.

Commonly Misspelled Medical and Academic Words

• accommodate (double c, double m)
• occurrence (double c, double r)
• definitely (not definately — there's no 'a')
• separate (not seperate — remember 'a rat' in separate)
• necessary (one c, double s)
• maintenance (main + ten + ance)
• hemorrhage (double r, then h-a-g-e)
• pharynx, larynx (ynx ending)
• diarrhea (double r, then h-e-a)
• conscientious (sci + en + tious)

Punctuation Rules Tested on the TEAS

Punctuation questions make up a significant portion of the English section. The TEAS focuses on practical punctuation usage in the context of clear, professional writing. Here are the rules tested most frequently.

Commas: The Five Essential Rules

• After introductory elements: "After the surgery, the patient rested comfortably."
• Between independent clauses joined by a coordinating conjunction (FANBOYS): "The nurse checked the vitals, and the doctor reviewed the chart."
• Around nonessential (nonrestrictive) clauses: "Dr. Smith, who specializes in cardiology, performed the procedure."
• Between items in a series: "The kit contains gloves, gauze, tape, and scissors." (The Oxford comma before 'and' is preferred on standardized tests.)
• Between coordinate adjectives: "The patient had a persistent, dry cough." (Test: if you can insert 'and' between the adjectives and the sentence still works, use a comma.)

Semicolons and Colons

A semicolon joins two closely related independent clauses without a conjunction: "The patient's fever broke; she was discharged the next morning." A semicolon also appears before conjunctive adverbs like however, therefore, and moreover when they connect independent clauses: "The test results were normal; however, the doctor ordered additional screening."

A colon introduces a list, explanation, or elaboration that follows a complete sentence: "The nurse prepared three items: a syringe, an alcohol swab, and a bandage." Remember that a colon must follow a complete independent clause. Do not use a colon after a verb or preposition: incorrect — "The symptoms include: fever, chills, and nausea." Correct — "The symptoms include fever, chills, and nausea" or "The patient exhibited several symptoms: fever, chills, and nausea."

Apostrophes

Apostrophes show possession or mark contractions. For singular nouns, add 's: the patient's chart, the nurse's station. For plural nouns ending in s, add only the apostrophe: the patients' rooms, the nurses' schedules. For irregular plurals (children, women), add 's: children's ward. The most tested apostrophe rule on the TEAS involves distinguishing between its (possessive) and it's (contraction of "it is"). Similarly: their/they're/there and your/you're.

Sentence Structure and Common Errors

The TEAS tests your ability to identify and correct structural problems in sentences. The three most common errors are run-on sentences, comma splices, and sentence fragments.

• Run-on sentence: Two independent clauses joined without punctuation or a conjunction. Fix by adding a period, semicolon, or comma + conjunction.
• Comma splice: Two independent clauses joined with only a comma. Fix by replacing the comma with a semicolon, adding a conjunction after the comma, or splitting into two sentences.
• Fragment: A group of words that lacks a subject, a verb, or a complete thought. Fix by attaching it to a nearby sentence or adding the missing element.

Subject-Verb Agreement Traps

The TEAS loves to test subject-verb agreement with tricky sentence constructions. The most common trap is placing a prepositional phrase between the subject and verb: "The collection of blood samples was sent to the lab" (not "were sent" — the subject is "collection," which is singular). Compound subjects joined by "and" take a plural verb, while subjects joined by "or" or "nor" match the verb to the nearest subject.

Watch for indefinite pronouns: everyone, everybody, each, either, neither are all singular. "Each of the patients was examined" is correct. "None" can be singular or plural depending on context: "None of the medication was wasted" (singular — medication) vs. "None of the patients were ready" (plural — patients).

Parallel Structure

Parallel structure means using the same grammatical form for items in a series or comparison. Incorrect: "The nursing program requires passing the TEAS, a background check, and to complete clinical hours." Correct: "The nursing program requires passing the TEAS, completing a background check, and finishing clinical hours." Each item should follow the same pattern (in this case, a gerund phrase). This is one of the most frequently tested writing conventions on the TEAS.

Study Strategy for the English Section

The English section is the shortest on the TEAS, which means each question carries more weight toward your overall score. Focus your study on the rules covered in this guide rather than trying to memorize every grammar exception. Read through the commonly misspelled words list daily for a week until they feel automatic. Practice identifying errors in real-world writing — emails, articles, even social media posts — to train your eye for mistakes. And always read every answer option before choosing, because the TEAS often includes answers that are partially correct but have a subtle error.