Main Idea Identification	The main idea is the central point the author wants to communicate. It is usually found in the first or last sentence of a paragraph, but can also be implied throughout. Distinguish between the TOPIC (what it's about) and the MAIN IDEA (what the author says about the topic).  Example: Passage about hand washing in hospitals. Topic = hand washing. Main idea = 'Proper hand hygiene protocols significantly reduce hospital-acquired infection rates.' The main idea makes a claim about the topic.
Supporting Details	Supporting details are facts, examples, statistics, and explanations that back up the main idea. They answer: who, what, where, when, why, and how. On the TEAS, detail questions ask you to locate specific information in the passage.  Example: Q: 'According to the passage, which factor most increases infection risk?' Scan for 'infection risk' or 'factor.' The answer will be in the text, not inferred.
Inferences & Conclusions	An inference is a logical conclusion based on evidence in the text. It goes beyond what is directly stated but is fully supported by the passage. A conclusion is the end result of reasoning from the evidence provided.  Example: Passage: 'Nurse Chen documented a 40% reduction in falls after implementing hourly rounding.' Valid inference: 'Hourly rounding was effective at reducing falls on Nurse Chen's unit.' Invalid: 'Hourly rounding prevents all patient falls.'
Author's Purpose	Every passage is written for a reason: to inform, persuade, entertain, or describe. Inform = present facts objectively. Persuade = convince the reader of a position. Entertain = amuse or engage. Describe = paint a detailed picture.  Example: Passage about the benefits of electronic health records that ends with 'Hospitals should adopt EHR systems immediately.' This is persuasive. The word 'should' is the tell.
Text Structure Patterns	Passages follow common structures: (1) Chronological/Sequence -- events in time order. (2) Cause & Effect -- why something happened and its results. (3) Compare & Contrast -- similarities and differences. (4) Problem & Solution -- issue presented and resolved. (5) Description -- characteristics and features.  Example: Passage starts with 'Before the 1950s, nurses recorded everything by hand. However, the introduction of computers changed documentation completely...' This is chronological with a turning point.
Topic Sentences	The topic sentence states the main idea of a paragraph. It is typically the first sentence but can appear anywhere. Some paragraphs have an implied topic sentence (you must infer it).  Example: Paragraph 2: 'Patient education is one of the most important nursing interventions. Studies show educated patients have better outcomes. They comply more with medication regimens and follow-up appointments.' Sentence 1 is the topic sentence. The rest are supporting details.
Summary Writing	A summary captures the main idea and key supporting points in condensed form. It excludes minor details, examples, and the summarizer's own opinion. A good summary is shorter than the original and covers only the essential content.  Example: Passage: 300 words about the history of nursing education. Good summary: 'Nursing education evolved from hospital-based apprenticeships in the 19th century to university degree programs today, driven by advances in medical knowledge and professionalization.'
Fact vs. Opinion	A fact can be proven true or false with evidence. An opinion expresses a belief, feeling, or judgment and cannot be objectively proven. The TEAS tests your ability to distinguish between the two.  Example: Fact: 'Hand sanitizer reduces bacterial counts by 99.9%.' Opinion: 'Hand sanitizer is the best way to prevent infection.' The first can be tested; the second is a judgment.
Context Clues	When you encounter an unfamiliar word, use the surrounding text to determine its meaning. Types: (1) Definition -- the word is defined in the sentence. (2) Synonym -- a similar word appears nearby. (3) Antonym -- an opposite word appears. (4) Example -- examples illustrate the meaning. (5) Inference -- general context suggests meaning.  Example: 'The doctor noted the patient's diaphoresis, evidenced by the visible perspiration on his forehead and neck.' Context clue: 'visible perspiration' = sweating. So diaphoresis = excessive sweating.
Sequence of Events	Many TEAS passages describe a process or timeline. Questions ask what happened first, last, or between two events. Identifying signal words helps: 'first,' 'next,' 'then,' 'after,' 'before,' 'finally,' 'subsequently,' 'meanwhile.'  Example: Passage about wound healing: 'First, hemostasis occurs. Next, inflammation begins. Then, new tissue forms. Finally, the wound remodels over months.' Timeline: 1. Hemostasis -> 2. Inflammation -> 3. New tissue -> 4. Remodeling.
Tone & Mood	Tone = the author's attitude toward the subject (objective, concerned, optimistic, critical). Mood = the feeling the reader gets (anxious, hopeful, inspired). The TEAS asks about tone more often than mood.  Example: Passage: 'Alarmingly, antibiotic resistance is spreading faster than previously thought, threatening to undo decades of medical progress.' Tone = alarmed/concerned. Words: 'alarmingly,' 'threatening.'
Graphic & Visual Information	The TEAS includes charts, graphs, tables, diagrams, and maps. Questions ask you to interpret data, identify trends, and draw conclusions from visuals. Read the TITLE, LABELS, and LEGEND before answering.  Example: Bar graph titled 'Infection Rates by Unit (2024).' X-axis: hospital units. Y-axis: infections per 1,000 patient days. Q: 'Which unit had the highest infection rate?' Scan the bars, find the tallest, read the label.
Author's Argument	An argument consists of a CLAIM (what the author wants you to believe) supported by EVIDENCE (facts, data, examples) and REASONING (how the evidence supports the claim). The TEAS asks you to evaluate whether the evidence adequately supports the claim.  Example: Claim: 'All nurses should meditate daily.' Evidence: 'One study of 30 nurses showed reduced stress after 8 weeks of meditation.' The evidence is promising but insufficient to support 'all nurses' -- the sample is small and the claim is broad.
Vocabulary in Healthcare Context	The TEAS reading section includes healthcare-related passages with domain-specific vocabulary. You don't need prior medical knowledge, but you DO need to understand words from context.  Example: 'The study examined the efficacy of the new vaccine.' Efficacy = effectiveness -- how well it works. Use context: 'The vaccine showed 95% efficacy, meaning 95% of recipients were protected.'
Compare & Contrast Passages	These passages present similarities (comparisons) and differences (contrasts) between two subjects. Signal words: 'similarly,' 'likewise,' 'in the same way' (compare). 'However,' 'on the other hand,' 'in contrast,' 'whereas' (contrast).  Example: Passage comparing Type 1 and Type 2 diabetes. Left (T1): autoimmune, childhood onset, insulin-dependent. Right (T2): insulin resistance, adult onset, managed with diet/exercise/oral meds. Differences are clear from the chart.
Order of Operations (PEMDAS)	Parentheses, Exponents, Multiplication/Division (left to right), Addition/Subtraction (left to right). This is the universal rule for evaluating expressions. Multiplication and division have EQUAL priority -- work left to right.  Example: Evaluate: 3 + 6 * (5 + 4) / 3 - 7. Step 1: Parentheses (5+4=9). Step 2: Mult/Div left to right: 6*9=54, then 54/3=18. Step 3: Add/Sub left to right: 3+18=21, then 21-7=14.
Fractions: Add & Subtract	To add or subtract fractions, find a common denominator (LCD). Convert each fraction to an equivalent fraction with the LCD. Add/subtract the numerators; keep the denominator. Simplify the result.  Example: 1/3 + 1/4. LCD of 3 and 4 = 12. 1/3 = 4/12. 1/4 = 3/12. Sum = 7/12. No simplification needed.
Fractions: Multiply & Divide	Multiply: multiply numerators, multiply denominators. Simplify. Divide: multiply by the reciprocal (flip the second fraction and multiply). Remember: 'Keep, Change, Flip' for division.  Example: Multiply: 2/5 * 3/4 = (2*3)/(5*4) = 6/20 = 3/10. Divide: 2/5 / 3/4 = 2/5 * 4/3 = 8/15.
Decimals & Percents	To convert fraction to decimal: divide numerator by denominator. To convert decimal to percent: multiply by 100 (move decimal 2 places right). To convert percent to decimal: divide by 100 (move decimal 2 places left).  Example: Convert 3/8 to percent: 3/8 = 0.375, 0.375 * 100 = 37.5%. Common equivalents: 1/2=50%, 1/3=33.3%, 1/4=25%, 1/5=20%, 1/8=12.5%, 1/10=10%.
Ratios & Proportions	A ratio compares two quantities (a:b). A proportion states that two ratios are equal (a/b = c/d). To solve: cross-multiply: a*d = b*c. Ratios can be simplified like fractions.  Example: If 3 tablets contain 150 mg, how many tablets for 250 mg? Proportion: 3/150 = x/250. Cross-multiply: 3*250 = 150x -> 750 = 150x -> x = 5 tablets.
Unit Conversions	TEAS tests metric conversions (kilo-, base, centi-, milli-, micro-) and some household/metric equivalents (1 inch = 2.54 cm, 1 kg = 2.2 lbs, 1 tsp = 5 mL, 1 oz = 30 mL). Know these COLD.  Example: Convert 65 inches to cm: 65 in * (2.54 cm / 1 in) = 165.1 cm. Convert 154 lbs to kg: 154 lbs * (1 kg / 2.2 lbs) = 70 kg.
Algebra: Solving Equations	To solve for x, isolate it on one side. Do the same operation to BOTH sides. Reverse the order of operations: undo addition/subtraction first, then multiplication/division, then exponents.  Example: 3x + 7 = 22. Step 1: Subtract 7 from both sides: 3x = 15. Step 2: Divide both sides by 3: x = 5. Check: 3(5) + 7 = 15 + 7 = 22. Correct.
Algebra: Word Problems	Translate English to algebra: 'more than' = +, 'less than' = -, 'times/of' = *, 'per' = /, 'is' = =, 'a number' = x. 'Five more than twice a number is 17' = 2x + 5 = 17.  Example: Q: 'A nurse spends 45 minutes with each patient. How many patients can she see in a 6-hour shift?' Setup: 6 hours = 360 minutes. 360/45 = 8 patients.
Mean, Median, Mode, Range	Mean = sum of values / number of values. Median = middle value when sorted (average of two middle values for even count). Mode = most frequent value(s). Range = max - min.  Example: Data: 72, 85, 85, 90, 94. Mean = 426/5 = 85.2. Median = 85. Mode = 85. Range = 94-72 = 22.
Graph Interpretation	TEAS includes bar graphs, line graphs, pie charts, and tables. Read the title, axis labels, and units before answering. Estimate when possible -- the TEAS rewards efficient approximation.  Example: Line graph: 'Patient admissions by month.' If the line rises steeply from Jan to March, admissions increased rapidly. If it's flat from March to June, admissions were stable.
Probability	Probability = number of favorable outcomes / total possible outcomes. Expressed as fraction, decimal, or percent. Probability ranges from 0 (impossible) to 1 (certain).  Example: Q: 'A class has 12 male and 18 female students. If one student is selected at random, what is the probability of selecting a male student?' A: 12/30 = 2/5 = 0.4 = 40%.
Roman Numerals	I=1, V=5, X=10, L=50, C=100, D=500, M=1,000. Rules: smaller before larger = subtract (IV=4, IX=9). Smaller after larger = add (VI=6, XI=11). You'll see Roman numerals in some TEAS questions.  Example: Convert XXIV: X=10, X=10, IV=4. Total: 10+10+4 = 24. Convert 47: 40=XL, 7=VII. Roman: XLVII.
Area & Perimeter	Rectangle: A = l*w, P = 2(l+w). Triangle: A = 1/2 * b * h. Circle: A = pi*r^2, C = 2*pi*r. The TEAS provides formulas but you must know which formula to use.  Example: Q: Rectangular room 12 ft by 15 ft. Area = 12*15 = 180 sq ft. Perimeter = 2(12+15) = 54 ft. Carpet covers area; baseboard covers perimeter.
Volume	Rectangular prism: V = l*w*h. Cylinder: V = pi*r^2*h. Know that 1 cubic cm (cc) = 1 mL. This conversion is critical for medication dosage questions.  Example: Q: A patient drinks 240 mL of water, 120 mL of juice, and 180 mL of soup. Total fluid intake = 240+120+180 = 540 mL. Document as 540 cc (same thing).
Scientific Notation	A way to write very large or very small numbers: N * 10^k where 1 <= N < 10. Positive k = large number. Negative k = small number. Used frequently in science passages.  Example: 4,500,000 = 4.5 * 10^6 (decimal moved 6 places left). 0.00032 = 3.2 * 10^-4 (decimal moved 4 places right).
Cell Structure & Function	Basic unit of life. Cell membrane (phospholipid bilayer, selectively permeable). Nucleus (contains DNA). Mitochondria (ATP production, 'powerhouse'). Ribosomes (protein synthesis). ER (transport). Golgi (packaging). Lysosomes (digestion).  Example: Q: Which organelle is responsible for energy production? A: Mitochondria. Q: Where does protein synthesis occur? A: Ribosomes (free or on rough ER).
DNA & RNA	DNA: double-stranded, deoxyribose, A-T and G-C base pairing, stores genetic information. RNA: single-stranded, ribose, A-U and G-C, helps make proteins. DNA replication: semi-conservative (each new DNA has one old and one new strand).  Example: If one DNA strand is ATCG, the complementary strand is TAGC. In RNA transcribed from ATCG, it would be UAGC (T replaced by U).
Mitosis & Meiosis	Mitosis: 1 cell -> 2 identical diploid cells (PMAT: Prophase, Metaphase, Anaphase, Telophase). For growth and repair. Meiosis: 1 cell -> 4 genetically different haploid cells. For reproduction (sperm/egg).  Example: Q: A skin cell divides to heal a wound. This is mitosis. Q: Sperm cells are produced through meiosis. Know the difference in purpose and outcome.
Genetics Basics	Gene = segment of DNA coding for a protein. Allele = variant of a gene. Dominant allele masks recessive. Genotype = genetic makeup (AA, Aa, aa). Phenotype = physical expression. Punnett square predicts offspring ratios.  Example: Q: Brown eyes (B) dominant over blue (b). Two heterozygous parents (Bb x Bb). Probability of blue-eyed child? bb = 1/4 = 25%. Use Punnett square to confirm.
Atoms & Elements	Atom = smallest unit of matter. Protons (+), Neutrons (neutral) in nucleus. Electrons (-) orbit nucleus. Atomic number = # of protons (defines the element). Atomic mass = protons + neutrons.  Example: Q: An atom has 6 protons, 6 neutrons, 6 electrons. Atomic number = 6 (Carbon). Atomic mass = 12. Charge = neutral (6 protons = 6 electrons).
Chemical Bonds	Ionic bond: transfer of electrons between metal and nonmetal (NaCl). Covalent bond: sharing of electrons between nonmetals (H2O). Hydrogen bond: weak attraction between H and O/N/F (gives water its properties).  Example: NaCl (table salt) dissolves in water because water molecules (polar) surround the Na+ and Cl- ions. This is why salt dissolves -- not because bonds break spontaneously.
Acids & Bases	Acid: pH < 7, donates H+ (protons). Base: pH > 7, accepts H+ or donates OH-. pH scale is logarithmic: each unit = 10x change in H+ concentration. Blood pH: 7.35-7.45 (slightly basic).  Example: Q: Which has a higher H+ concentration -- pH 3 or pH 5? pH 3 (lower pH = more acidic = more H+). pH 3 has 100x more H+ than pH 5 (10^2 difference).
States of Matter	Solid: fixed shape and volume. Liquid: fixed volume, takes shape of container. Gas: no fixed shape or volume. Plasma: ionized gas. Phase changes: melting, freezing, vaporization, condensation, sublimation.  Example: Q: What happens to water molecules during boiling? A: They gain enough energy to overcome intermolecular forces and escape as gas. Temperature stays at 100 C during boiling (energy goes into phase change, not temp increase).
Periodic Table Basics	Elements arranged by atomic number. Rows = periods (same # electron shells). Columns = groups (same # valence electrons, similar properties). Key groups: Group 1 (alkali metals), Group 17 (halogens), Group 18 (noble gases).  Example: Q: Why are sodium (Na) and potassium (K) chemically similar? A: Both are in Group 1, so each has 1 valence electron. They form +1 ions and react similarly with water.
Scientific Method	Steps: Observation -> Question -> Hypothesis -> Experiment -> Data Analysis -> Conclusion. Hypothesis must be testable and falsifiable. Independent variable = what you change. Dependent = what you measure. Control = what stays the same.  Example: Experiment: 'Does fertilizer increase plant growth?' Independent variable = fertilizer (some plants get it, some don't). Dependent variable = plant height (what you measure). Control group = plants with no fertilizer.
Macromolecules	Four types: (1) Carbohydrates -- energy (sugars, starches). (2) Lipids -- long-term energy, cell membranes (fats, oils). (3) Proteins -- structure, enzymes, signaling (amino acid chains). (4) Nucleic acids -- genetic info (DNA, RNA).  Example: Q: Which macromolecule is the primary component of cell membranes? A: Lipids (phospholipid bilayer). Q: Enzymes belong to which class? A: Proteins.
Enzymes	Biological catalysts that speed up reactions without being consumed. Lower activation energy. Specific to substrates (lock and key model). Affected by temperature and pH -- each enzyme has an optimal range.  Example: Lactase breaks down lactose (milk sugar). Optimal pH ~6. At pH 2 (stomach acid), lactase denatures -- this is why lactase supplements are enteric-coated (to survive stomach acid).
Cellular Respiration	Glucose + O2 -> CO2 + H2O + ATP. Three stages: (1) Glycolysis (cytoplasm, 2 ATP). (2) Krebs Cycle (mitochondria, 2 ATP). (3) Electron Transport Chain (mitochondria, ~32-34 ATP). Total: ~36-38 ATP per glucose.  Example: Q: Why do muscles produce lactic acid during intense exercise? A: Oxygen delivery can't keep up; cells switch to anaerobic respiration, which produces lactic acid as a byproduct.
Photosynthesis	6 CO2 + 6 H2O + light -> C6H12O6 + 6 O2. Occurs in chloroplasts. Light reactions (thylakoid): capture light, produce ATP and NADPH. Calvin cycle (stroma): uses ATP/NADPH to make glucose.  Example: Q: What gas is consumed during photosynthesis? A: CO2 (carbon dioxide). Q: What gas is produced? A: O2 (oxygen). Q: Where does photosynthesis occur? A: Chloroplasts (in plant cells).
Atoms in Biology	CHNOPS: Carbon, Hydrogen, Nitrogen, Oxygen, Phosphorus, Sulfur -- the six most abundant elements in living organisms. Carbon is the backbone of all organic molecules.  Example: Q: Why is carbon uniquely suited for biological molecules? A: It forms 4 stable covalent bonds, enabling chains, branches, and rings -- the structural diversity needed for complex biomolecules.
Subject-Verb Agreement	A singular subject takes a singular verb. A plural subject takes a plural verb. Ignore prepositional phrases between subject and verb. 'The nurse (singular) with many patients (plural) IS tired' -- NOT 'are.'  Example: The group of students (is/are) studying. Subject = group (singular). Verb = is. 'Of students' is a prepositional phrase -- ignore it. The results of the test (is/are) in. Subject = results (plural). Verb = are.
Pronoun-Antecedent Agreement	A pronoun must agree in NUMBER and GENDER with its antecedent (the noun it replaces). 'Each nurse must wash (his or her / their) hands.' Formal English: 'his or her' (each = singular). Modern usage increasingly accepts 'their.'  Example: The patient said that (he or she / they) felt better. If the patient's gender is known, use he or she. If unknown, formal grammar prefers 'he or she.' 'The nurses said that (his or her / their) shifts were long.' Nurses = plural, use 'their.'
Comma Usage	Use commas: (1) Between items in a series (I need gloves, a mask, and a gown). (2) After introductory phrases (After the exam, go home). (3) Before coordinating conjunctions joining independent clauses (I studied, and I passed). (4) Around nonessential information (The nurse, who has 20 years of experience, retired).  Example: Incorrect: 'I studied hard yet I failed.' Correct: 'I studied hard, yet I failed.' (Two independent clauses, coordinating conjunction = comma needed.) Correct: 'After studying for hours, I felt prepared.' (Introductory phrase = comma needed.)
Apostrophes	Apostrophes show: (1) Possession -- nurse's notes (one nurse), nurses' notes (multiple nurses). (2) Contractions -- can't (cannot), it's (it is), don't (do not). DO NOT use apostrophes for plurals.  Example: The hospital updated (it's / its) policies. Can you say 'it is policies'? No. So possessive = its (no apostrophe). (It's / Its) important to wash your hands. 'It is important...' Yes! So contraction = it's.
Semicolons	Use semicolons between two closely related independent clauses WITHOUT a conjunction. 'I studied for weeks; I passed the TEAS.' Also use between items in a complex list that already contains commas.  Example: Correct: 'The patient was discharged; however, follow-up was scheduled.' (Semicolon before 'however' + comma after.) Incorrect: 'The patient was discharged, however, follow-up was scheduled.' (Comma splice -- two complete sentences joined by only a comma.)
Commonly Confused Words	There (location), Their (possessive), They're (they are). To (direction), Too (also/excessively), Two (number). Accept (receive), Except (excluding). Affect (verb, to influence), Effect (noun, result). Then (time), Than (comparison).  Example: 'The medication will (affect/effect) your blood pressure.' Action = affect (verb). 'The (affect/effect) of the medication was immediate.' Result = effect (noun).
Sentence Fragments	A complete sentence must have a SUBJECT and a PREDICATE (verb) and express a complete thought. A fragment is missing one of these. 'Because I was tired.' -- Fragment. 'I went to bed because I was tired.' -- Complete.  Example: Fragment: 'Administering the medication to the patient.' (No main verb -- 'administering' is a gerund, not a tensed verb.) Complete: 'The nurse is administering the medication to the patient.'
Run-On Sentences	A run-on joins two or more independent clauses without proper punctuation. Fix by: (1) Period (separate sentences). (2) Semicolon. (3) Comma + coordinating conjunction (and, but, or, so, yet).  Example: Run-on: 'The patient was admitted he required surgery.' Fix 1: 'The patient was admitted. He required surgery.' Fix 2: 'The patient was admitted; he required surgery.' Fix 3: 'The patient was admitted, and he required surgery.'
Dangling Modifiers	A modifier describes something. If the thing being described is missing or in the wrong place, the modifier 'dangles.' Fix: make sure the modified word is right next to the modifier.  Example: Incorrect: 'After studying for hours, the test seemed easy.' Who studied? The test didn't study. Fix: 'After studying for hours, I found the test easy.'
Parallel Structure	Items in a series or comparison must have the same grammatical form. 'The nurse enjoys reading, to write, and running.' Fix: all gerunds (-ing) OR all infinitives (to + verb). 'The nurse enjoys reading, writing, and running.'  Example: Incorrect: 'Nursing requires compassion, being patient, and to have knowledge.' Fix: 'Nursing requires compassion, patience, and knowledge.' (All nouns). Or: '...requires being compassionate, being patient, and being knowledgeable.'
Verb Tense Consistency	Don't shift tenses without reason. If a passage is in past tense, stay in past tense unless describing a universal truth or a future event relative to the narrative.  Example: Incorrect: 'Yesterday, the patient reports pain and the nurse administered medication.' (Shift from present to past.) Fix: 'Yesterday, the patient reported pain and the nurse administered medication.' (All past.)
Wordiness & Redundancy	Concise expression is preferred. Eliminate phrases that add no meaning: 'due to the fact that' -> 'because.' 'In the event that' -> 'if.' 'At this point in time' -> 'now.' Redundant: 'past history,' 'advance planning,' 'basic fundamentals.'  Example: Wordy: 'It is important to note that hand washing is an essential practice.' Concise: 'Hand washing is essential.' Wordy: 'The reason why she left is because she was ill.' Concise: 'She left because she was ill.'
Capitalization	Capitalize: (1) Proper nouns (Mercy Hospital, Dr. Chen). (2) Titles before names (Nurse Rodriguez). (3) Days and months (Monday, January). (4) First word of a sentence. Do NOT capitalize: seasons (spring), generic terms (the hospital), directions (north).  Example: Capitalize: Medicare, Medicaid, English, Spanish, MRI (acronym), Department of Nursing. Do NOT capitalize: nurse, doctor (unless part of name), x-ray (unless at start of sentence).
Spelling: Medical Terms	Commonly misspelled medical words: abscess (not abcess), aneurysm (not anurism), cirrhosis (not cirrosis), hemorrhage (not hemmorhage), ophthalmology (not opthamology), psoriasis (not psorasis), rhythm (not rythm).  Example: 'The patient has _____ (cirrhosis/cirrosis).' The correct spelling is cirrhosis (double r). Think: 'cirrh-' from Greek for 'yellow' (as in jaundice).
Contextual Word Meaning	Many TEAS English questions ask you to determine a word's meaning from context. Read the sentence before and after. Predict a meaning. Match to answer choices. The word may have an unexpected secondary meaning.  Example: 'The nurse had to temper her frustration when dealing with the difficult patient.' 'Temper' here means 'to moderate or restrain' -- not 'to apply heat to metal' or 'anger.' Context tells you which meaning.
