It can be way more than that, depending on where you live.
Each state has 2 senators, and a number representatives based on population, these are they folks that go to Washington DC. The state is divided into districts for the representatives, based on population. My state (Nevada) has 4, but the state being mostly empty two of them are massive in area. Two of the districts cover the Las Vegas metro area, and by area are pretty small. The other two are each half the [remainder of the state.](https://en.wikipedia.org/wiki/Nevada%27s_congressional_districts)
There are also state level equivalents of the US Senate and House of Representatives, called the Assembly and Nevada Senate. The state is also divided into districts for those, again based on population.
Getting smaller, most states are also divided into counties, and in those counties cities, so I also get to vote for County Commission members, and also City Council Members and Mayor.
Of the above, the terms vary and they stagger them, so they are not all up for election every time.
My State also elects Judges, so they are on the ballot as well, as are members of the school board, and a bunch of other minor government positions.
We also do both statewide and county wide ballot questions, where laws can be changed/enacted directly by the people. This year we have 8 of them, 7 for the state, and one for the county.
So this year, I will have 18 items on my ballot, 10 people, and 8 questions.
President/VP, Senator, US Representative, State Assembly, County Commission, three state supreme court justices, Member of the state board of education, a local judge, seven state ballot questions, and one County ballot question.
On Edit, for clarity: This is how my state does it, I believe most do similar, but not always.
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