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TEAS English and language usage study guide

The TEAS English and language usage section is the last of the four: 37 questions in 37 minutes, 33 of them scored, in three content areas: conventions of standard English (12 questions), knowledge of language (11) and using language and vocabulary to express ideas in writing (10) (ATI exam details). To study for it, learn the rule families below (spelling, punctuation, sentence structure, agreement, clarity, word meaning and the writing process), then drill them at one question a minute.

This guide gives you every rule family with examples, the English minimums programs publish, 10 practice questions with the reason for each answer, and a 14-day plan.

What is on the TEAS English section?

ATI splits the section into three content areas. The counts below are scored questions; four more are unscored pretest questions you can't tell apart (what is on the TEAS test has the whole exam).

Question counts and minutes are ATI's. The "what it tests" column follows the content area names and the topic lists prep publishers give for each (Archer Review, Nurse.org). English expanded in Version 7, compared with TEAS 6 (ATI: TEAS 6 vs TEAS 7), so older English books can miss topics.

Is the TEAS English section hard?

The rules are ones you met in school; the clock is what makes it hard. English gives you 60 seconds a question, the least time per question of any section (reading is about 73 seconds, science 72, math 90). It also comes last, after more than two and a half hours of testing. Most questions are four-option multiple choice, but TEAS 7 also has multiple select, fill in the blank, ordered response and hot spot questions, and none of them give partial credit (ATI: question types).

What that means for studying: knowing a rule isn't enough. You need to spot which rule a question tests within a few seconds. That's why every section below ends with "how it shows up", and why the plan finishes with timed sets.

What English score do nursing programs ask for?

Most programs set an overall TEAS minimum, not an English one. Some set a minimum for each section, and then English matters on its own. From the programs in our list:

With 33 scored questions, each one is worth about 3 percentage points of your English score before ATI's form adjustment, so two or three avoidable misses can be the gap to a 60% minimum. All 56 programs' numbers are in what TEAS score you need; the TEAS score calculator turns your correct answers into section percents.

Conventions of standard English: spelling

Spelling questions ask you to pick the correctly spelled word, or the misspelled one in a sentence. Most misses come from a handful of rules and from words that sound alike.

• i before e, except after c when the sound is "ee": believe, receive, ceiling. Exceptions to know: weird, seize, either, neither, foreign, height.
• Final silent e drops before a vowel suffix: hope → hoping, care → caring; it stays before a consonant suffix: hope → hopeful, care → careful. Keep it after soft c or g before -able/-ous: noticeable, courageous.
• Final y after a consonant becomes i: carry → carried, happy → happiness; keep it before -ing: carrying. After a vowel, y stays: play → played.
• Double the final consonant of a one-syllable word ending consonant-vowel-consonant before a vowel suffix: stop → stopped, run → running. For longer words, double only if the last syllable is stressed: occur → occurred, begin → beginning, but open → opened.
• Plurals: add -es after s, x, z, ch, sh (boxes, churches); consonant + y → -ies (stories); some f/fe → -ves (knife → knives); irregular plurals you should know on sight: children, women, teeth, mice, criteria, phenomena.

How it shows up: four spellings of one word, or a sentence with one word misspelled. Say each option quietly and check it against the rule it falls under, not against what "looks right".

Conventions of standard English: punctuation and capitalization

• Comma with a joining word: two complete sentences joined by and, but, or, so, for, nor, yet take a comma before the joining word. "The nurse checked the chart, and the doctor signed it."
• Comma after an introduction: "After the shift ended, she charted."
• Commas around extra information: "My sister, who is a nurse, lives in Ohio." No commas when the clause tells you which one: "Students who study daily improve."
• Commas in a list: "pulse, blood pressure, and temperature." The last comma (Oxford comma) is accepted; be consistent.
• No comma splice: two complete sentences can't be joined by a comma alone. Use a period, a semicolon, or a comma plus a joining word.
• Semicolon: joins two closely related complete sentences ("The test is long; bring water.") or separates list items that already contain commas.
• Colon: after a complete sentence, to introduce a list or explanation. "Bring three things: ID, login and a pencil." Not after "are" or "include" mid-sentence.
• Apostrophes: singular possessive 's (the patient's chart), plural possessive s' (the patients' charts), irregular plural 's (the children's ward). Never in possessive pronouns: its, yours, hers, theirs.
• Quotation marks: in American English, periods and commas go inside: "He said he was fine."
• Capitals: proper nouns (Ohio, Monday, Tylenol), titles before names (Dr. Patel, but "the doctor"), the first word of a sentence and of a quoted sentence. Not seasons (spring), or subjects unless they are languages (biology, but English).

How it shows up: "Which sentence is punctuated correctly?" with four versions that differ by one mark. Find the two complete sentences or the extra clause first; the right mark follows from that.

Conventions of standard English: sentence structure

You need to name the four sentence types and fix the two broken ones.

• Fragment: a group of words missing a subject, a verb, or a complete thought. "Because the lab was closed." Fix by joining it to a sentence: "We waited because the lab was closed."
• Run-on: two sentences with nothing between them. "The test starts at nine it ends at one." Fix with a period, a semicolon, or ", and".
• Dependent clause starters (signal a complex sentence): although, because, since, when, while, if, unless, after, before, who, which, that.

How it shows up: "What type of sentence is this?" Count the clauses that could stand alone, then look for a dependent clause starter.

Knowledge of language: grammar for clarity

• Subject-verb agreement: find the real subject and skip the phrase between. "The box of gloves is empty" (box, not gloves). Each, every, either, neither and everyone take a singular verb. With "either…or", the verb agrees with the nearer subject: "Either the nurses or the doctor is on call."
• Pronoun agreement and case: a pronoun matches what it stands for ("Each student brought her or his ID" in formal writing). Use I/he/she/we/they as subjects and me/him/her/us/them as objects: "between you and me", "She and I studied."
• Clear pronouns: "When Ana met Jo, she was nervous" doesn't say who. Name the person.
• Verb tense: keep one tense unless the time really changes. "She checked the chart and calls the doctor" shifts for no reason.
• Modifiers: put a describing phrase next to what it describes. "Running to class, my phone fell" says the phone ran. Fix: "Running to class, I dropped my phone."
• Parallel structure: items in a list or comparison share a form. "She likes reading, writing and to swim" → "reading, writing and swimming."
• Adjective or adverb: adverbs describe verbs ("She did well", "He feels bad" is right because feel is a linking verb). Comparatives: better (two), best (three or more).

Knowledge of language: formal language, paragraphs and transitions

Formal vs informal. Questions describe a reader (a professor, a hiring manager, a friend) and ask which sentence fits. Formal writing has no slang, contractions or text speak, and states things directly: "The results were unexpected," not "The results were kind of crazy." Informal is right for a note to a friend; the question tells you the reader.

Paragraphs. A paragraph has one main idea, often in its first sentence, with details that support it. "Which sentence doesn't belong?" questions hide a sentence on a different topic. "Which order is logical?" questions want the topic sentence first and the conclusion last; follow time order and the transition words.

How it shows up: a blank between two sentences. Decide the relationship (do they agree, disagree, or does one cause the other?) before you look at the options.

Using language and vocabulary: word meaning

Context clues. When a word is new, the sentence usually gives you the meaning in one of five ways:

• Definition: "Edema, or swelling, …"
• Synonym: "The pain was acute; it was sharp and sudden."
• Antonym or contrast: "Unlike her gregarious brother, she was shy."
• Example: "Analgesics, such as ibuprofen and acetaminophen, …"
• General sense: "The ward was so quiet that the alarm seemed deafening."

Try each answer in place of the word and reread the sentence. The right one keeps both the grammar and the meaning.

Word parts. Prefixes, roots and suffixes let you work out words you have never seen, and many health words are built from them.

Using language and vocabulary: the writing process and sources

Expect questions that describe what a writer is doing and ask which step it is, or what to do next.

1. Prewriting: choosing a topic, brainstorming, outlining, researching.
2. Drafting: getting the ideas down in sentences and paragraphs.
3. Revising: changing content and order: adding support, cutting what is off topic, moving paragraphs.
4. Editing: fixing grammar, spelling and punctuation.
5. Publishing: the final copy for its reader.

Revising is about ideas; editing is about mechanics. "Moving a paragraph" is revising; "correcting a comma" is editing. That one distinction answers many of these questions.

Using sources. Paraphrasing or quoting someone else's words or ideas needs a citation; common knowledge does not. A thesis statement says what the whole essay argues, usually at the end of the introduction. Evidence that supports a claim beats an opinion that repeats it.

10 TEAS English practice questions

Our own questions in the style of the section. Give yourself 10 minutes for all ten, then check the reasons.

1. Which word is spelled correctly? A) recieve B) occurence C) beginning D) noticable

   C. Begin is stressed on its last syllable, so the n doubles. The others are receive, occurrence, noticeable.

2. Which sentence is punctuated correctly? A) The lab opened late, the results were delayed. B) The lab opened late; the results were delayed. C) The lab opened late the results were delayed. D) The lab opened late: and the results were delayed.

   B. Two complete sentences need a semicolon, a period, or a comma plus a joining word. A is a comma splice, C a run-on, D misuses the colon.

3. "The box of syringes ___ on the counter." A) are B) were C) is D) have been

   C. The subject is box, which is singular; "of syringes" doesn't change it.

4. What type of sentence is this? "When the alarm sounded, the nurse checked the monitor, and the patient woke up." A) simple B) compound C) complex D) compound-complex

   D. Two independent clauses (the nurse checked…, the patient woke up) and one dependent clause (When the alarm sounded).

5. Which sentence has a misplaced modifier? A) Walking into the clinic, I saw the sign. B) Walking into the clinic, the sign caught my eye. C) I saw the sign as I walked into the clinic. D) The sign caught my eye as I walked into the clinic.

   B. It says the sign was walking.

6. "The new schedule saves time; ___, it costs more." A) therefore B) for example C) however D) furthermore

   C. The second idea contrasts with the first.

7. A student is writing to a program director. Which sentence fits best? A) I'm super excited to apply! B) I am writing to ask about the spring application deadline. C) Hey, when's the deadline? D) Just checking on the deadline thing.

   B. Formal, complete and direct; the others are informal.

8. "The doctor said the condition was benign, so no treatment was needed." Benign most nearly means: A) harmful B) not harmful C) painful D) spreading

   B. bene- means good, and "no treatment was needed" confirms it.

9. A writer moves her third paragraph to the start of the essay. Which step is this? A) prewriting B) drafting C) revising D) editing

   C. Changing order and content is revising; editing fixes mechanics.

10. Which sentence uses parallel structure? A) She likes charting, reviewing labs, and to teach. B) She likes to chart, reviewing labs, and teaching. C) She likes charting, reviewing labs, and teaching. D) She likes chart, reviewing labs, and teach.

    C. All three items share the -ing form.

For more mixed questions across all four sections, try our TEAS sample questions. To see your English score next to Reading, Math and Science, scored against your program's minimum, take the free TEAS practice test.

A 14-day TEAS English study plan

About 45 minutes a day. If your test is sooner, fold this into the one-week TEAS plan; if you have a month, run it inside the four-week plan.

Keep an error note for every miss: the rule, why your answer was wrong, and one new example of your own. Notes like that are what you review on day 12.

Mistakes that cost points on TEAS English

• Choosing what sounds right. Spoken English allows "me and him went"; the test doesn't. Name the rule, then pick.
• Reading the options before the sentence. Find the subject, the clauses, or the relationship first.
• Stopping at the first good option on multiple select questions: there is no partial credit, so check every option.
• Spending three minutes on one question. At 60 seconds each, flag it, answer your best guess, and move on; there is no penalty for a wrong answer, so never leave a blank.
• Leaving English for the last few days. It's the last section on test day, not the least important. Some programs set an English minimum of their own.
• Using a TEAS 6 book. English changed in Version 7; check your material against the three content areas above.

TEAS English FAQ

How many questions are on the TEAS English section?

37 questions in 37 minutes: 33 scored and 4 unscored pretest questions.

Is there an essay on the TEAS English section?

No. Every question is multiple choice or one of ATI's other formats (multiple select, fill in the blank, ordered response, hot spot). You are tested on writing skills, not asked to write an essay.

Is TEAS English the hardest section?

It has the fewest questions, but the least time per question: 60 seconds. Many applicants find science or math harder; English trips people who don't practise at that pace.

What is a good TEAS English score?

Whatever clears your program's number. Where programs set an English minimum, the ones in our list ask for 50% to 70%. Most programs set only an overall minimum.

Does spelling count on the TEAS?

Yes. Spelling is part of the conventions of standard English content area, which has 12 scored questions with punctuation, capitalization and sentence structure.

How long should I study for TEAS English?

Two weeks at about 45 minutes a day covers every rule family above, as in the plan. If a practice test already shows English well above your program's minimum, spend that time on your weakest section instead.

Sources

• ATI, ATI TEAS exam details (sections, questions, minutes, content areas). Read for our format guide, October 2026.
• ATI, question types on the ATI TEAS Version 7 and TEAS 6 vs TEAS 7.
• Archer Review, TEAS 7 English and language usage; Nurse.org, TEAS English lessons: topic lists per content area. Read 2026-11-01.
• Program English minimums: each program's own page, linked above and in our program list.

More guides: TEAS reading study guide, what is on the TEAS test, TEAS sample questions, how many times you can retake the TEAS, or all guides. To find out whether English is where your points are, take the free practice test.