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How to choose between words that sound alike

6 min lesson 2 min for the key points

Fact-checked October 15, 2026

HESI A2 topic: Confusing word pairs

In 30 seconds
  • Expand any apostrophe word: it's means it is or it has.
  • Affect is usually a verb; effect is usually a noun.
  • Lay, set and raise take an object; lie, sit and rise don't.
  • Fewer is for things you can count; less is for amounts.
  • Use between for two, among for three or more, who for people.

Key facts

  1. Its, their, your and whose show ownership and never take an apostrophe; it's, they're, you're and who's are contractions.
  2. Affect is usually a verb meaning to influence; effect is usually a noun meaning a result.
  3. Accept means to receive or agree; except means excluding. Advice is a noun; advise is a verb.
Show all 7 key factsShow fewer
  1. Lie (recline) has the forms lie, lay, lain; lay (put) has lay, laid, laid and always takes an object.
  2. Set and raise take an object (set the tray down, raise your hand); sit and rise do not.
  3. Fewer is for things you can count (fewer forms); less is for amounts you can't count (less water).
  4. Ordinarily, use between for two and among for three or more; use who for people and that or which for things.

Quick check1 question · 2 more at the end

Which word best completes the sentence? The students left ___ backpacks in the hallway.

Full lesson

Each part starts with its main idea. Open a part when you want the details.

The short answer: Most confusing pairs have a quick test. Expand any apostrophe word (it's = it is, they're = they are). Affect is usually a verb and effect usually a noun. Lay, set and raise take an object; lie, sit and rise do not. Use fewer for things you can count, between for two, and who for people.

1 Why do these word pairs cause so many mistakes?These words sound alike or have related meanings, so your ear can't separate them. 1 min

These words sound alike or have related meanings, so your ear can't separate them. Elsevier's HESI A2 review book covers troublesome word pairs; each one below has a quick test.

2 Which pairs can you check by expanding a contraction?If a word has an apostrophe, expand it and reread the sentence. 1 min

If a word has an apostrophe, expand it and reread the sentence. If the long version makes no sense, you need the other spelling. Ownership words such as its, their and your never take an apostrophe.

Pair Rule Example
its / it's its = belonging to it; it's = it is or it has It's late, and the clinic changed its hours.
their / there / they're their = belonging to them; there = a place or "there is"; they're = they are They're leaving their coats over there.
your / you're your = belonging to you; you're = you are You're next, so bring your card.
to / too / two to = toward, or with a verb (to swim); too = also or excessively; two = 2 Two of us went to the lab, and Sam came too.
than / then than compares; then = at that time or next Lunch was later than usual, and then we left.
3 Which pairs differ in meaning or part of speech?Many pairs split into a verb and a noun, or into two separate meanings. 1 min

Many pairs split into a verb and a noun, or into two separate meanings. Decide what job the word is doing first.

Pair Rule Example
affect / effect affect is usually a verb (to influence); effect is usually a noun (a result) Noise can affect sleep; one effect is fatigue.
accept / except accept = receive or agree to; except = excluding We accept every form except the old one.
advice / advise advice is a noun; advise is a verb I advise you to take her advice.
principal / principle principal = head of a school, or main; principle = a basic rule or truth Her principal concern was the principle of fairness.
lose / loose lose = misplace or fail to win; loose = not tight Don't lose that loose button.
imply / infer the speaker implies (suggests); the listener infers (concludes) His tone implied a delay, so we inferred we'd start late.
farther / further farther = physical distance; further = more or additional The lab is farther down the hall; we need further discussion.
4 How do you choose lie or lay, sit or set, rise or raise?In each pair, one verb takes a direct object and the other does not. 1 min

In each pair, one verb takes a direct object and the other does not. Ask "___ what?" after the verb; if there is an answer, use lay, set or raise.

No object Takes an object
lie (recline): lie, lay, lain, lying lay (put): lay, laid, laid, laying
sit: sit, sat, sat set: set, set, set
rise: rise, rose, risen raise: raise, raised, raised

The big trap is that lay is also the past tense of lie. "Yesterday I lay down for a nap" is correct; "Yesterday I laid down" is wrong unless you put something down.

5 When do you use fewer, between or who?These pairs depend on the noun they describe, so look at that noun before you choose. 1 min

These pairs depend on the noun they describe, so look at that noun before you choose.

  • Fewer vs. less: fewer for things you can count (fewer forms, fewer visitors); less for amounts you can't count (less water, less time).
  • Between vs. among: between for two (between the two clinics); among for three or more (among the five volunteers).
  • Who vs. that or which: who for people (the nurse who called); that or which for things. That starts information the sentence needs; which usually starts extra information set off by commas.

Some guides allow between for three or more separate items, or that for people. On a test, the conservative rule is safe.

Common mistakes

The traps students fall into most. Read these before you practice.

  • Watch out: Lay is also the past tense of lie, so Yesterday I lay down is correct and Yesterday I laid down is not.

  • Watch out: Its' is never correct, and it's always means it is or it has.

  • Watch out: A speaker or writer implies (suggests); a listener or reader infers (concludes), so a reader cannot imply anything from a text.

  • Watch out: Principal is the head of a school or means main (the principal reason); principle is a noun meaning a basic rule or truth.

  • Watch out: We have further questions, not farther questions: farther is for physical distance, and further means more or additional (further is also used for distance, but farther is the safer choice there).

How to remember it

Two short memory hooks cover the most common traps in this lesson. RAVEN means Remember, Affect is a Verb, Effect is a Noun. For the verb pairs, lay, set and raise always need something to lay, set or raise.

Self-check:

  1. Expand the contraction: is "Its raining again" correct?
  2. Choose the verb: "The dog (lies / lays) in the sun every afternoon."
  3. Fill the blank: "We had ___ (fewer / less) visitors than last week."
Show answers
  1. No. It should be "It's raining again."
    • Expand it: "It is raining again" makes sense.
    • So you need the contraction it's, with an apostrophe.
  2. Lies.
    • Ask "lies what?" There is no answer, because the dog is not putting anything down.
    • With no object, use lie (recline). The dog lies in the sun.
  3. Fewer.
    • Visitors are things you can count.
    • Use fewer for things you can count and less for amounts you can't count.
Check yourself

Try it: 2 questions

  • 2 questions
  • Grammar
  • 5 min in exam mode

Questions are original practice items written to the published exam content, not real exam questions.

Finished this lesson? It is marked done when you finish the questions above. You can also mark it yourself.
Sources (5)
  1. OpenStax Writing Guide with Handbook, Handbook (Table H4, Words Commonly Confused)
  2. Purdue OWL, Spelling: Common Words that Sound Alike
  3. Purdue OWL, Commonly Confused Verbs
  4. Missouri Western State University Center for Academic Support, Commonly Confused Words (PDF)
  5. Northern Illinois University Writing Tutorial, Commonly Confused Words

Written with AI and checked against the sources above by a separate review step. No teacher or nurse reviews this content. How we make our content. HealthcareExams is independent and not affiliated with Elsevier.

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