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TEAS 7 English & Language Usage: 10 Grammar Rules You Must Know

By Dr. James Okafor, Ph.D. ยท Updated March 7, 2026

Open English grammar textbook with notes for TEAS 7 preparation
How do you pass TEAS English Language usage?

Master spelling rules, identify complex vs. compound sentences, and know your punctuation strictly. You must understand the mechanics of writing, not just what 'sounds right', to secure a high score in this dense section.

English & Language Usage is the shortest TEAS 7 section โ€” but it's also the one students lose the most "easy" points on. Here's how to lock in a high score without spending weeks studying grammar rules.

Section Structure

The English & Language Usage (ELU) section has 37 questions in 37 minutes โ€” exactly 1 minute per question. It tests three areas:

๐Ÿ“‹ From the Tutor's Desk:

I frequently see students bomb the TEAS English section because they rely on what "sounds right." Spoken English is full of grammatical errors. When a question tests subject-verb agreement with intervening prepositional phrases (e.g., 'The box of chocolates are on the table'), it will 'sound' correct to your ear. You have to physically cross out the preposition ('of chocolates') to see the error ('The box are').

  • Conventions of Standard English (~55%) โ€” Grammar, punctuation, sentence structure, and spelling.
  • Knowledge of Language (~17%) โ€” Tone, style, word choice, and clarity.
  • Using Language & Vocabulary (~28%) โ€” Word roots, prefixes, suffixes, and context-based definitions.

The 10 Grammar Rules Most Tested on the TEAS

1. Subject-Verb Agreement
Singular subjects need singular verbs: "The nurse administers medication." Plural subjects need plural verbs: "The nurses administer medication." Watch out for interrupting phrases: "The box of syringes is on the shelf" (not "are").

2. Comma Splices
Two independent clauses cannot be joined by just a comma. Wrong: "She studied all night, she passed the exam." Fix it with a semicolon, coordinating conjunction, or separate sentences.

3. Run-On Sentences
Two complete sentences fused together without punctuation: "She studied all night she passed the exam." Always look for where one complete thought ends and another begins.

๐Ÿ’ก Tutorโ€™s Tip: The number one grammar trap on the TEAS is subject-verb agreement with prepositional phrases. 'The box of chocolates IS on the table' โ€” not 'are.' Cross out everything between subject and verb. I've watched 200+ students fall for this.

4. Pronoun Agreement
Pronouns must match their antecedent in number and gender. Wrong: "Each student should bring their textbook." Correct: "Each student should bring his or her textbook."

5. Apostrophes
Possessives use apostrophes: "The patient's chart." Plurals don't: "The patients were discharged." "It's" = "it is." "Its" = possessive.

6. Their / There / They're
Their = possessive. There = location. They're = they are. The TEAS tests this in nearly every exam version.

7. Affect vs. Effect
Affect is usually a verb (to influence): "The medication affects blood pressure." Effect is usually a noun (a result): "The effect was immediate."

8. Parallel Structure
Items in a list must follow the same grammatical form. Wrong: "She likes running, swimming, and to bike." Correct: "She likes running, swimming, and biking."

9. Semicolons
Use between two related independent clauses: "She studied for three hours; she felt confident about the exam." Never use a semicolon before a coordinating conjunction (and, but, or).

10. Colon Usage
Use a colon after a complete sentence to introduce a list, explanation, or example: "She needed three items: a stethoscope, a pen, and her badge."

Word Roots, Prefixes & Suffixes

You can decode almost any medical or academic term if you know common word parts. Here are the highest-yield ones:

๐Ÿ’ก Tutorโ€™s Tip: Run-on sentences show up in at least 3-4 questions. Here's my rule: if you see two complete thoughts joined by just a comma, it's always wrong. That alone is worth 8-10 points on the English section.
Part Meaning Example
hyper-above, excessivehypertension
hypo-below, deficienthypoglycemia
anti-againstantibacterial
-itisinflammationbronchitis
-ologystudy ofcardiology
-ectomysurgical removalappendectomy
brady-slowbradycardia
tachy-fasttachycardia

Study Plan for the ELU Section

Since this section is relatively short, you don't need to spend weeks on it. Here's a focused 5-day plan:

  • Day 1โ€“2: Review the 10 grammar rules above. Take notes on any you're unsure about.
  • Day 3: Memorize 15โ€“20 word roots from the table. Create flashcards.
  • Day 4: Take a timed TEAS practice quiz focusing on English questions.
  • Day 5: Review mistakes. Re-drill any rules you got wrong.

Sentence Types You Need to Recognize

The TEAS tests your ability to identify and work with four sentence types. Understanding these helps you answer structure-based questions confidently:

  • Simple sentence: One independent clause. "The nurse checked the patient's vitals."
  • Compound sentence: Two independent clauses joined by a coordinating conjunction (FANBOYS: for, and, nor, but, or, yet, so) or semicolon. "The nurse checked the vitals, and the doctor reviewed the chart."
  • Complex sentence: One independent clause + one or more dependent clauses. "After the nurse checked the vitals, the doctor reviewed the chart."
  • Compound-complex sentence: Two independent clauses + at least one dependent clause. "After the nurse checked the vitals, the doctor reviewed the chart, and the pharmacist prepared the medication."

Parts of Speech Quick Review

While the TEAS doesn't directly ask "What part of speech is this word?", understanding parts of speech helps you answer grammar, word choice, and sentence correction questions:

Part of Speech Function Example
NounNames a person, place, thing, or ideaThe patient rested.
VerbExpresses action or state of beingShe administered the shot.
AdjectiveDescribes a nounThe sterile gloves.
AdverbDescribes a verb, adjective, or adverbShe worked quickly.
PrepositionShows relationship between a noun and another wordThe chart is on the desk.
ConjunctionConnects words, phrases, or clausesShe studied and passed.

Commonly Confused Words on the TEAS

Beyond their/there/they're and affect/effect, the TEAS frequently tests these confusing word pairs:

  • Than vs. Then: Than compares ("She scored higher than me"). Then indicates time ("Study first, then take the test").
  • Who vs. Whom: Who is the subject ("Who administered the medication?"). Whom is the object ("To whom was it administered?"). Trick: if you can replace it with "he/she," use who. If "him/her," use whom.
  • Fewer vs. Less: Fewer for countable items ("fewer patients"). Less for uncountable things ("less time").
  • Lay vs. Lie: Lay requires an object ("Lay the chart on the table"). Lie does not ("Lie down and rest").
  • Accept vs. Except: Accept means to receive. Except means to exclude.
  • Compliment vs. Complement: Compliment is praise. Complement means to complete or go well with.

Formal vs. Informal Language

The TEAS tests whether you can identify the appropriate level of formality for a given context. In academic and professional writing:

  • Avoid contractions in formal writing ("do not" instead of "don't").
  • Avoid slang ("The results were very good" not "The results were lit").
  • Use third person in academic writing ("The study shows..." not "I think...").
  • Choose precise words over vague ones ("The medication reduced inflammation" not "The medication helped the thing").

Spelling Patterns Worth Memorizing

The TEAS includes spelling questions. While you can't memorize every word, knowing these rules covers most cases:

  • i before e, except after c: believe, receive, achieve (exceptions: weird, science, seize).
  • Drop the silent e before -ing: make โ†’ making, give โ†’ giving (but keep it before -ment: arrange โ†’ arrangement).
  • Double the consonant when adding -ed/-ing to short words ending in consonant-vowel-consonant: run โ†’ running, stop โ†’ stopped.
  • Change y to i before -es or -ed: study โ†’ studies, carry โ†’ carried (but not before -ing: studying, carrying).

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Frequently Asked Questions

How many questions are on the TEAS 7 English section?
The English & Language Usage section has 37 questions to be completed in 37 minutes (1 minute per question). It's the shortest TEAS section, but that tight pace means you need to know the rules cold โ€” there's no time to deliberate.
Is the TEAS English section hard?
Most students find it easier than Reading or Science because the grammar rules are finite and predictable. If you study the 10 most-tested rules and practice word roots, you can realistically score 80%+ with just one week of focused study.
What's the highest-yield topic to study for TEAS English?
Subject-verb agreement and comma splices appear on virtually every TEAS exam. If you only have time to study two things, master those. After that, focus on apostrophes, pronoun agreement, and parallel structure.
Does the TEAS 7 test vocabulary?
Yes. The 'Using Language & Vocabulary' category makes up about 28% of the English section. Questions focus on word roots, prefixes, suffixes, and using context clues to determine word meaning. You won't be asked to define obscure words from memory โ€” it's about applying decoding strategies.
Should I study English grammar rules from a textbook?
A full grammar textbook is overkill. The TEAS tests a specific set of rules repeatedly. Focus on the 10 rules listed in this guide, learn 20-30 word roots, and practice with TEAS-specific questions. Our free practice quiz covers the exact question types you'll see on test day.
Can I improve my TEAS English score quickly?
Yes โ€” English is the most 'crammable' TEAS section. Students who follow our 5-day study plan typically improve their English score by 15-20 percentage points. The key is active practice: don't just read the rules, do practice questions and review every wrong answer.

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