4.1 Clauses and Complete Sentences

Why Clauses Drive TEAS Sentence Structure

Sentence structure is a core Conventions of Standard English skill on the ATI TEAS 7 English and Language Usage section. Before you can label a sentence as simple, compound, or complex—or fix a fragment, run-on, or comma splice—you must recognize clauses. A clause is a group of words that contains a subject and a predicate (the verb and the words that complete it). Not every clause is a complete sentence. TEAS writers build many items around that single distinction.

Healthcare writing makes the same distinction matter in practice. Chart notes, patient education handouts, and incident reports must state complete actions: who did what, and when the thought is finished. A hanging clause such as "Because the patient reported chest pressure" is incomplete documentation just as it is incomplete on an exam.

Subject + Predicate: The Floor, Not the Ceiling

Every clause has two structural pieces:

Examples of clauses (subject + predicate present):

• The nurse documented the allergy. (subject nurse; predicate documented the allergy)
• When the saturation dropped below 90%. (subject saturation; predicate dropped below 90% — still not a complete sentence)

Not a clause (missing subject, missing verb, or both):

• After the morning assessment (prepositional phrase only)
• Checking two identifiers carefully (participial phrase; no finite verb + subject pair in standard clause form)
• The new fall-prevention protocol on 4 West (noun phrase only)

TEAS stems sometimes present phrases dressed up with clinical vocabulary so they sound complete. Ignore the medical content for a moment and ask: Is there a clear subject performing a finite verb action (or state of being)?

Independent vs. Dependent Clauses

Independent Clauses

An independent clause has a subject and a predicate and expresses a finished idea. It can be a full sentence by itself.

• The patient ambulated to the bathroom with a gait belt.
• Pain decreased after the medication.
• The pharmacy clarified the insulin order.

If you can place a period after the clause and a reader is not left waiting for "because of what?" or "when?" or "who?" as unfinished business, you likely have an independent clause.

Dependent Clauses

A dependent clause also has a subject and a predicate, but a subordinating word (or relative pronoun) makes the thought incomplete. The clause depends on an independent clause to finish the meaning.

• Because the patient ambulated to the bathroom with a gait belt… (Why are you telling me this? What happened?)
• When pain decreased after the medication… (What occurred at that time?)
• If the pharmacy clarified the insulin order… (Then what?)

Healthcare charting example: "Although the wound edges appeared approximated" is not a finished note. Attach it: "Although the wound edges appeared approximated, serous drainage was still present on the dressing."

Subordinating Conjunctions You Must Recognize

Memorize this high-yield set. TEAS items lean heavily on these openers for dependent clauses:

Other common subordinators you should also treat as "dependent flags" include after, before, until, as, even though, whereas, so that, and provided that. The seven listed above appear especially often in academic test language.

Pattern to lock in:

1. Subordinator + subject + predicate = dependent clause
2. Dependent clause + independent clause (or the reverse) = complex sentence (covered in the next section)
3. Dependent clause alone = fragment (covered in 4.3)

Comma preview with openers: When a dependent clause opens the sentence, a comma usually follows before the independent clause: "If the culture is positive, start antibiotics per protocol." When the independent clause comes first, many TEAS-style academic sentences omit the comma before a short because clause: "Start antibiotics per protocol if the culture is positive." Structure recognition matters more than comma debates here—but knowing the opener pattern helps you see where the independent clause begins.

Relative Clauses: Who, Which, That

A relative clause (also called an adjective clause) modifies a noun. It begins with a relative pronoun such as who (people), which (things, often nonessential), or that (things or people in essential clauses). Relative clauses contain a subject-verb relationship (sometimes the relative pronoun is the subject), but they cannot stand alone.

Standalone relative clauses are fragments:

• Incorrect as a sentence: Who verified the dose.
• Incorrect as a sentence: That reduced falls on the night shift.
• Incorrect as a sentence: Which the educator reviewed during orientation.

Essential vs. nonessential (structure link to punctuation): Essential relative clauses identify which noun you mean and usually take no surrounding commas (patients who have shellfish allergies). Nonessential relative clauses add extra information about an already identified noun and take commas (Ms. Ortiz, who has a shellfish allergy,). On pure structure items, both types are still dependent on a main clause.

Healthcare charting example: "Notify the provider who is covering medicine tonight" uses an essential who clause to identify which provider. The clause is not a sentence by itself.

The Complete Thought Test (TEAS Decision Tool)

Use this three-step test on every sentence-structure stem:

1. Find subject + finite verb. If either is missing, you have a phrase or fragment, not a clause-based complete sentence.
2. Check for a subordinating or relative marker at the start (or immediately after a noun for relative clauses). Markers often mean the clause is dependent.
3. Ask: Would a careful reader feel the idea is finished? If the group of words only sets a time, reason, condition, contrast, or identifier without stating the main outcome, it fails the complete-thought test.

Trap — long fragments: Length does not equal completeness. "Although the night nurse carefully reassessed pain, documented the numeric score, and notified the charge nurse about the trend" can still be incomplete if it never delivers an independent clause that stands as the main statement—or if the whole stretch remains under Although without a main-clause finish. Always locate the main independent claim.

Trap — commands and implied subjects: Instructions such as "Document two identifiers" are complete sentences in standard English; the subject you is understood. TEAS usually focuses more on missing verbs, bare subordinate clauses, and relative-clause hangers than on imperative mood, but do not mark a clear command as a fragment solely because you is unstated.

Putting It Together for Exam Speed

On timed TEAS items, underline (mentally) every because / although / when / if / since / while / unless and every who / which / that clause. Ask whether each marked stretch is attached to a true independent clause. If the answer choice is only the dependent piece, it is not a complete sentence. If two independent clauses are present, you will next decide how they should be joined (next sections). If one independent clause stands alone with no illegal partner, you likely have a simple complete sentence.

Clinical mini-drill (think, do not only reread):

• "When the patient's temperature reached 39°C." → incomplete (needs what the nurse did or what followed).
• "The patient's temperature reached 39°C." → complete.
• "The patient whose temperature reached 39°C received acetaminophen per protocol." → complete (relative clause embedded; main clause has subject patient and verb received).
• "Whose temperature reached 39°C." → incomplete relative fragment.

Master this clause map and every later sentence-structure rule becomes easier: compound and complex labels, fragment repairs, and "which revision corrects" stems all rest on seeing independence versus dependence at a glance.