The ATI TEAS Version 7 devotes one of its four sections to English and Language Usage — 37 questions in 37 minutes, covering everything from parts of speech to comma placement. For many pre-nursing students, this is the sneaky section: it feels easy while you read it and punishes you when the answer choices look "all fine." The good news is that...
Know the Terrain: What the Section Actually Tests
The TEAS 7's English and Language Usage section contains 37 questions (33 scored and 4 unscored pretest items) in 37 minutes — the shortest section on the exam. ATI TEAS Exam Details Content clusters:
- Grammar & usage — sentence structure, subject-verb agreement, pronoun agreement, verb tense
- Punctuation & mechanics — commas, semicolons, colons, apostrophes, capitalization
- Spelling & commonly confused words — affect/effect, its/it's, and friends
- Context-dependent word choice — choosing the word that fits the sentence's meaning
Roughly half of your time-per-question is under a minute, so you need instant recognition of error patterns, not slow rule recall.
Part 1: Subject-Verb Agreement — The Five Classic Traps
The rule is simple: singular subjects take singular verbs; plural subjects take plural verbs. The TEAS makes it hard by hiding the subject.
- The prepositional phrase trap: In "The box of chocolates is on the shelf," the subject is box, not chocolates. Cross out every prepositional phrase ("of X," "with Y," "in Z") before choosing the verb.
- Compound subjects: Two subjects joined by and take a plural verb ("The nurse and the doctor are on call"). But subjects joined by or or nor agree with the closer subject ("Neither the doctor nor the nurses were available").
- Indefinite pronouns: Each, every, either, neither, anybody, everybody, nobody, someone are always singular ("Everyone is invited"). Both, few, many, several are plural. Some, most, all, none depend on the noun they refer to.
- Collective nouns: Team, committee, staff, family are singular in American English ("The committee has decided").
- Sentences that begin with "There": The subject comes after the verb ("There are three reasons" — not "There is three reasons").
Part 2: Pronoun Agreement and Case
- Agreement: Pronouns must match their antecedents in number and gender ("Each student must bring their own book" is technically informal; the TEAS prefers "his or her" or a properly singular pronoun — when in doubt, match the singular antecedent).
- Case — the who/whom rule: Use who for the subject of a clause, whom for the object. Quick test: if you can replace the pronoun with he/she, use who; with him/her, use whom.
- Between you and me: After prepositions (between, with, for, to, from), use object pronouns (me, him, her, us, them). "Between you and I" is a trap — it is always wrong.
Part 3: Punctuation That Appears Over and Over
Commas
Use a comma: - To separate items in a series (the TEAS accepts both with and without the Oxford comma — be consistent). - After an introductory phrase or clause ("Before the surgery, the patient fasted."). - Around nonessential clauses ("The nurse, who had worked for ten years, led the training."). - Before coordinating conjunctions (and, but, or, so, yet) joining two complete sentences ("She studied all night, but she still felt unprepared.").
Do not use a comma between the subject and its verb, or before "that."
Semicolons and Colons
- Semicolon: joins two complete, closely related sentences without a conjunction ("The lab results were normal; the patient was discharged.").
- Colon: introduces a list, explanation, or quotation (after a complete sentence) ("She brought three items: a stethoscope, a penlight, and a notepad.").
Apostrophes
- Possession: singular noun +
's(the nurse's chart); plural ending in s +'(the nurses' lounge); irregular plurals +'s(the children's wing). - Contractions: apostrophe replaces missing letters (can't, don't, it's).
- The its/it's trap: its = possessive ("the heart and its valves"); it's = "it is" or "it has." If you can expand it, use the apostrophe; if not, don't.
Part 4: The 12 Confusing Word Pairs the TEAS Loves
| Pair | Quick rule | Example |
|---|---|---|
| Affect / Effect | Affect = verb ("to influence"); Effect = noun ("result") | The drug affected her heart rate; its main effect was sedation. |
| Its / It's | Its = possessive; It's = "it is" | It's true that the heart has its own pacemaker. |
| Their / There / They're | Their = possessive; There = place; They're = "they are" | They're moving the beds there to match their plan. |
| To / Too / Two | To = preposition; Too = "also/excessively"; Two = number | I need to go too; there are two tests. |
| Then / Than | Then = time; Than = comparison | First study, then rest; math is harder than reading. |
| Lay / Lie | Lay = put down (takes object); Lie = recline (no object) | Lay the chart down; let the patient lie still. |
| Less / Fewer | Less = uncountable; Fewer = countable | Fewer questions, less time. |
| Who / Whom | Who = subject; Whom = object | Who called? To whom do I speak? |
| Good / Well | Good = adjective; Well = adverb (and "healthy") | She did well; she is a good nurse. |
| Accept / Except | Accept = receive; Except = excluding | We accept all insurance except that plan. |
| Advice / Advise | Advice = noun; Advise = verb | Her advice is to advise patients kindly. |
| Principle / Principal | Principle = rule; Principal = main/head | The principal cause; the principle of care. |
Part 5: Sentence Structure and Verb Tense
- Fragments are incomplete sentences ("Because the patient was stable."). Fix by attaching to a full sentence or removing the subordinating word.
- Run-ons and comma splices join two complete sentences incorrectly ("She studied hard, she passed" is a comma splice). Fix with a period, semicolon, or conjunction.
- Tense consistency: Once a sentence establishes a time frame, keep it. "The nurse checked the vitals and documented them" — not "checked ... documents."
- Dangling modifiers attach to the wrong noun ("After running the test, the results were reviewed" — who ran the test?). Rewrite so the modifier has a clear subject.
Part 6: Capitalization in 30 Seconds
Capitalize: the first word of a sentence; proper nouns and adjectives (names, cities, languages, specific institutions — Mercy General Hospital); the first word of a full quotation; the major words in titles. Do not capitalize: seasons, most after-colon text, or general terms like "the nursing program" when not a specific title.
Your 4-Week Study Plan for This Section
- Week 1: Master Parts 1–2 (agreement + pronouns). Do 20 practice questions daily, logging every error by rule name.
- Week 2: Master Part 3 (punctuation) and Part 4 (confusing words). Build a personal flashcard deck from this table.
- Week 3: Master Parts 5–6, then take a full timed English section; target 33+ correct.
- Week 4: Mixed drills in 37-minute blocks; review your error log twice; re-learn any rule with two or more misses.
Free high-quality drills exist — ATI's own practice tests, plus reputable TEAS prep sites — but the single highest-value tool is your own error log keyed to rules, not questions.
Conclusion
Grammar on the TEAS is not arbitrary trivia; it is a fixed menu of ~30 recurring rules. You now have the complete cheat sheet — the five agreement traps, the punctuation rules that actually show up, the twelve word pairs that trip everyone, and a four-week plan to lock it in. Print this, drill it daily, and the English and Language Usage section becomes one of your highest subscores instead of your quiet worry.
Next step: Open a free TEAS practice test right now, complete only the English and Language Usage section, and categorize every miss against this sheet. Your weakest rule becomes this week's study target.
