Word Choice, Spelling & Common Errors

Precise word choice is critical in healthcare communication. Using the wrong word in a medication order or patient chart could have serious consequences. The HESI A2 tests your ability to select the correct word and avoid common errors.

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Commonly Confused Word Pairs

These words are frequently tested on the HESI A2:

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Affect vs. Effect — A Closer Look

This is the most commonly tested word pair on the HESI A2:

Affect (verb) = to influence or have an impact on

• "How will this medication affect the patient's heart rate?"
• "Stress can affect healing."

Effect (noun) = the result or outcome

• "What is the effect of this medication on blood pressure?"
• "The side effects include drowsiness."

Memory Trick: RAVEN = Remember, Affect = Verb, Effect = Noun

Exception: Effect can be used as a verb meaning "to bring about" (rare):

• "The new policy will effect change in the department." (bring about change)

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Double Negatives

A double negative occurs when two negative words are used in the same clause, creating a positive meaning (which is usually not the writer's intent):

Common negative words: no, not, never, nothing, nobody, nowhere, neither, hardly, barely, scarcely

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Redundancy and Wordiness

Redundant expressions use unnecessary words that repeat the same meaning:

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Spelling Rules

1. I before E except after C:

• believe, receive, achieve, conceive
• Exceptions: weird, seize, neither, foreign, height, leisure, science

2. Doubling consonants before -ed / -ing:

• If a word ends in consonant-vowel-consonant (CVC) AND is one syllable or stressed on the last syllable → double the final consonant
• run → running, stop → stopped, begin → beginning
• Do NOT double: visit → visited (stress on first syllable), open → opening

3. Dropping the silent "e" before vowel suffixes:

• hope → hoping, write → writing, use → usable
• Keep the e before consonant suffixes: hope → hopeful, use → useless

4. Changing y to i:

• If a word ends in consonant + y → change y to i before adding a suffix: carry → carried, happy → happiness
• If a word ends in vowel + y → keep the y: play → played, enjoy → enjoyment

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Formal vs. Informal Language

The HESI A2 tests your understanding of formal academic and clinical language:

In nursing documentation, always use formal language:

• Avoid slang and abbreviations not on the approved list
• Use precise medical terminology
• Write in third person (not "I" or "you")
• Avoid contractions in formal writing

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Common Grammar Mistakes in Healthcare Writing

"Who" vs. "Whom" rule:

• Who = subject (who is performing the action) → "Who is the attending physician?"
• Whom = object (who is receiving the action) → "To whom should I send the report?"
• Test: If you can replace with "he/she," use "who." If you can replace with "him/her," use "whom."

"Less" vs. "Fewer" rule:

• Fewer = countable nouns → "fewer patients," "fewer pills," "fewer errors"
• Less = uncountable nouns → "less time," "less pain," "less fluid"

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Commonly Misspelled Medical/Academic Words

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Sentence Clarity and Conciseness

The HESI A2 may test your ability to identify the clearest, most concise version of a sentence:

Wordy vs. Concise:

In nursing documentation, concise writing saves time and reduces ambiguity. Choose the most direct expression of your meaning.