Do I need to replace all 4 tires at once?

Like others have said, Fix-A-Flat is not a repair. It is a stop-gap measure to allow you to get to a place where you can get the tire properly patched or replaced…AND MANY VARIETIES OF FIX-A-FLAT ARE FLAMMABLE!!!

Leaving the nail in the tire is even more bone-headed! Even if the worst cheapskate hack would remove the nail and plug the tire himself!