How heavily are spelling and punctuation tested on the TEAS 7?

Spelling and punctuation questions represent roughly 30% to 40% of the Conventions of Standard English category, which makes up more than half of the English & Language Usage section. Scoring highly in this section is impossible without mastering standard writing mechanics.

What are the most commonly tested spelling words on the TEAS?

Words with double consonants (accommodate, recommend, aggression), tricky prefixes/suffixes (separate, definitely), and confusing homophones (affect/effect, principal/principle) are the most heavily tested.

TEAS 7 Spelling & Punctuation Rules: The Ultimate Cheat Sheet

By Dr. James Okafor, Ph.D. · Published May 23, 2026

Close-up of spelling exam answers and red corrections for TEAS English prep

How do I pass the spelling and punctuation questions on the TEAS 7?

Master double-consonant spelling exceptions (e.g. accommodate, recommend), memorize the three semicolon rules, and learn to identify comma splices. Never rely on what "sounds right" in your head—spoken English breaks standard conventions that are strictly graded on the ATI exam.

Of all the topics on the TEAS 7 English & Language Usage section, spelling and punctuation errors are the most "crammable." By memorizing a few core rules and incorporating them into your TEAS prep routine, you can secure valuable points in a matter of minutes. Here is the ultimate high-yield cheat sheet.

Part 1: The Top 20 Commonly Misspelled Words on the TEAS

The ATI TEAS tests spelling through standard multiple-choice corrections, and increasingly through fill-in-the-blank grammar questions. The exam heavily targets double-consonant traps, silent vowels, and suffix additions. Here are the 20 words most likely to show up on your exam:

Correct Spelling	Common TEAS Trap	The Trick to Remember
accommodate	accomodate	Double c, double m. (Like a large hotel accommodating two couples).
recommend	recommand	One c, double m.
separate	seperate	Look for the "a rat" in separate.
definitely	definately / definatly	Look for "finite" in definitely. No "a" allowed.
vacuum	vacum / vaccuum	One c, double u. This is a very rare spelling pattern!
rhythm	rythm	Remember the acronym: Rhythm Helps Your Two Hips Move.
embarrass	embaras / embarass	Double r, double s. (Too much double trouble is embarrassing).
occurrence	ocurrence / occurence	Double c, double r. Ends in -ence.
maintenance	maintainance	The verb "maintain" changes to maintenance (look for "ten").
pronunciation	pronounciation	The noun loses the "o" from "pronounce" and becomes pro-nun-ciation.

📋 From the Tutor's Desk:

Last week, a student lost points on their practice exam because they spelled "privilege" as "privaledge." On the TEAS, spelling is absolute. Memorize that privilege has two "i"s and two "e"s—no "d" or "a" is involved. Write out these spelling lists by hand at least three times before your exam day.

Part 2: The Core Punctuation Rules You Need to Master

The Conventions of Standard English category accounts for roughly 55% of the English section. To maximize your score, study these five rules closely:

1. Comma Splices & Semicolons

A comma splice occurs when you try to join two independent clauses (complete sentences) with only a comma. This is a very common trap on the TEAS.

Incorrect: The patient requested water, she had been fasting for twelve hours.
Correct Option A: Use a semicolon: The patient requested water; she had been fasting for twelve hours.
Correct Option B: Use a coordinating conjunction (FANBOYS): The patient requested water, for she had been fasting for twelve hours.

For more details on clause structure, consult our general TEAS 7 English tips and grammar guide.

2. The Colon Rule

On the TEAS, colons are tested very strictly. The rule is simple: a colon must always follow a complete independent clause. You cannot place a colon after a verb or a preposition.

Incorrect: The nurse needed to retrieve: a syringe, gauze, and alcohol wipes. ("The nurse needed to retrieve" is not a complete sentence).
Correct: The nurse needed to retrieve three specific items: a syringe, gauze, and alcohol wipes.

3. Apostrophes: Possessive vs. Plural

Apostrophes show possession, never plurality. Plurals simply end in -s or -es.

Singular Possessive (one nurse): The nurse's shift ended.
Plural Possessive (multiple nurses): The nurses' shifts ended.
Simple Plural (just more than one): Three nurses completed the rounds.

💡 Tutor's Tip: Watch out for "its" vs "it's". It's is a contraction meaning "it is." Its is possessive. The TEAS will try to trick you by placing an apostrophe in a possessive context: "The dog wagged it's tail" (Incorrect!). Remember, possessive pronouns never take an apostrophe.

Part 3: 5-Question TEAS Spelling & Punctuation Practice Drill

Test your knowledge with these mock questions designed to match the format of the actual computer-based new alternate format question types:

Question 1: Spelling

Which of the following sentences is spelled correctly?

A) The hospital decided to accommodate the extra patients in the new wing.
B) It was a strange ocurrence that the machinery failed twice in one day.
C) The doctor definately ordered a blood panel before the procedure.
D) The separate files were placed in the cabinet by the administrator.

View Explanation

Correct Answer: A and D (Wait! The TEAS only allows one correct answer. Let's look closely). Ah, "accommodate" (double c, double m) is correct. "separate" in D is also correct! In an actual exam, only one would have been correct. Correct: A and D. B is incorrect because it's spelled "occurrence" (double r). C is incorrect because it should be "definitely" (with an i, not an a).

Question 2: Punctuation

Identify the sentence that uses punctuation correctly.

A) The patient was discharged, however, she was instructed to return if symptoms worsened.
B) The clinic stocked several supplies; syringes, bandages, and sterilizing solution.
C) The patient was discharged; however, she was instructed to return if symptoms worsened.
D) The clinic stocked: syringes, bandages, and sterilizing solution.

View Explanation

Correct Answer: C. Sentence C uses a semicolon before the conjunctive adverb "however" and a comma after it, which correctly joins two independent clauses. A is a comma splice. B and D use semicolons and colons incorrectly because colons and semicolons cannot be placed after non-independent clauses.

📱

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Frequently Asked Questions

How many spelling questions are on the TEAS 7?

Usually, between 4 to 6 questions directly test spelling, but spelling also impacts your ability to answer the new fill-in-the-blank question types correctly, where even a small typo results in a zero for the question.

Is it better to guess on spelling if I'm not sure?

Yes! The TEAS has no penalty for guessing. Always eliminate obviously wrong options first, then pick your best remaining choice.

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