Pharm II - Review for Final Questions

A client alerts the nurse that they have been in menopause for a couple of months. The nurse teaches the client how menopause occurs. Which statement reflects the teaching has been effective?

"Estrogen and progesterone diminish."

The nurse educates a client about using the prescribed otic 0.5% hydrocortisone, 10,000 units polymyxin B, 4 drops QID in right ear x 10 days. Which client statements determine the need for further clarification?

"I will place the bottle tip into the ear and instill the 4 drops."

After teaching a client how to administer eye drops, the nurse determines that additional teaching is needed when the client makes which statement?

"I'll drop the solution into the nasal side of the lower eye sac."

A nurse is teaching a client about the prescribed potassium replacement therapy which the client will continue at home. After teaching the client about this therapy, the nurse determines that additional teaching is warranted when the client makes which statement?

"If I have trouble swallowing the drug, I can crush it."

The health care provider has ordered a variety of laboratory assessments on a client who will need estrogen replacement. The follow labs are ordered: Blood Urea Nitrogen (BUN), creatinine, and Liver Function Tests (LFTs). What is the nurse's best statement explaining to a client the need to draw the labs?

"The labs will identify your body's ability to filter and excrete medications."

After teaching the caregiver of a client prescribed transdermal rivastigmine, the nurse determines that the teaching was successful when the caregiver articulates which comment?

"The patch should be placed on a hairless area."

A caregiver of a client diagnosed with AD asks the nurse about galantamine. Which response by the nurse would be most appropriate?

"These drugs help to slow the progression of the disease."

A client who is prescribed phenazopyridine is distressed seeing reddish-orange colored urine. Which response by the nurse would be most appropriate?

"This discoloration is a normal result of the medication."

A nurse is prepared to administer a varicella vaccine to a female client planning to start a family. How long after the vaccination should the nurse instruct the client to wait before getting pregnant?

12 weeks

A nursing instructor is teaching a class illustrating the various reactions to antivenins. The instructor determines the class is successful when the students correctly point out clients may react within which time period if they are sensitive to an antivenin?

30 minutes

The nurse is assessing a client who is to receive multiple vaccinations. Which nursing diagnosis should the nurse prioritize for this client?

Acute Pain

A nurse has administered bismuth to a client with diarrhea. Which intervention should the nurse perform to promote an optimal response to the prescribed drug therapy?

Administer the drug after each loose bowel movement.

A client with intestinal stenosis is showing signs of colon obstruction after beginning psyllium. What intervention should the nurse prioritize?

Administer the drug with adequate fluid intake.

A child is brought to the health care center for MMR vaccination. On assessment, the nurse discovers that the child had received an antivenin injection for a snake bite 2 days before. When should the nurse instruct the caregivers to return for this vaccine for this child?

After 6 to 8 weeks

The primary health care provider has prescribed dexamethasone for a client being treated for immunologic skin disorder. Assessment of which finding would lead the nurse to suspect that the client is experiencing an adverse reaction to the drug?

Allergic contact dermatitis

A nurse is preparing to administer ferrous to a client. Which adverse reaction should the nurse point out to the client to report if noted?

Allergic reaction

The nurse is preparing to administer cisplatin to a client. The nurse anticipates the client will also be prescribed which drug to counteract some adverse reactions?

Amifostine

A nursing instructor has finished teaching a session about the different types of CNS stimulants. The instructor determines the session was successful when the students correctly place drugs used for narcolepsy in which category?

Analeptic

The nurse is performing an ongoing assessment on a client who received rivastigmine for AD. Which noted assessment finding should the nurse prioritize?

Anorexia and nausea

A nursing student has explained CNS stimulants and their uses in a class presentation. After completing the presentation, the student determines that additional explanation is necessary when the class chooses which category as a CNS stimulant?

Antipsychotic

A nurse in the emergency department is assessing a client who has been bitten by a coral snake. Which drug does the nurse predict the client will be given as treatment?

Antivenin

A client comes to the clinic and tells the nurse that close family members are suspected of having pulmonary tuberculosis. Which vaccine would the nurse predict the health care provider will prescribe as a preventative measure?

BCG vaccine

The nursing instructor is teaching a session explaining the various drugs used to treat urinary tract infections. The instructor determines the session is successful when the students correctly choose which organ as most often affected by infections?

Bladder

The nurse is caring for a client who is prescribed mesalamine and warfarin. Which potential assessment finding should the nurse prioritize in this client?

Bleeding

A client is prescribed tamsulosin and atenolol. Which assessment would the nurse prioritize when conducting the ongoing assessment?

Blood pressure

A nurse is caring for a client prescribed gemcitabine. On the morning laboratory results, the nurse discovers the following: white blood cell count 4500/mm3 and platelets 135,000/mm3. The nurse anticipates discovering which signs on the ongoing assessment?

Bloody urine

A client, who has been prescribed melphalan for the treatment of an ovarian tumor, wants to know how the drug acts. Which response would the nurse integrate into the answer?

Changes to a more alkaline cell environment

The nurse is preparing a client for abdominal surgery. Which product will the nurse plan to use to cleanse the proposed surgical site? Select all that apply.

Chlorhexidine Hexachlorophene

A nurse is caring for a client with iron deficiency anemia who is receiving iron supplements. What information should the nurse point out in the teaching plan for this client?

Color of stools will become darker.

A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment?

Complete blood count

A client with AD is prescribed. Which finding on assessment should the nurse prioritize?

Confusion

A nurse has administered cimetidine to an older adult client. Which assessment findings should the nurse prioritize?

Confusion and dizziness.

A nurse determines a nursing diagnosis of Constipation is appropriate for a client receiving iron supplements. Which suggestion would be appropriate for the nurse to recommend to the client to promote resolution of this problem?

Consume a diet high in fiber

A client has been prescribed benzphetamine. The nurse would question administering this drug if which is noted in the client medical record?

Currently takes an antidepressant.

The nurse is using chlorhexidine on a client for preoperative skin preparation. Which finding on the ongoing assessment should the nurse prioritize?

Deafness

The nurse is conducting an ongoing assessment on a client who has received methylphenidate. Which finding would the nurse anticipate if the medication is therapeutic? Group of answer choices

Decreased appetite

A nurse is preparing to administer oxybutynin to a client and discovers the client is also prescribed haloperidol. The nurse predicts the client has the increased risk of which reaction related to the concomitant use of both drugs?

Decreased effect of haloperidol

A nurse is preparing to administer lidocaine viscous to a client scheduled for minor surgery. Which instruction regarding the intake of food should the nurse give the client?

Do not eat food for 1 hour after use.

After teaching a group of nursing students about laxatives, the instructor determines that the teaching was successful when the students correctly choose which drug as producing the laxative effect by promoting water retention and softening the stool?

Docusate

The nurse is administering trifluridine to a client with epithelial keratitis. The nurse will prioritize which finding on the ongoing assessment of this client?

Edema of the eyes

The nurse notes a client with AD and receiving a cholinesterase inhibitor is losing weight on the ongoing assessment. Which action will the nurse prioritize when providing care to this client?

Encourage careful chewing.

What additional warnings or risks should the nurse include in the teaching plan of a client receiving estrogen?

Endometrial cancer.

A nursing instructor is evaluating the students' understanding of topical anti-infectives. The instructor determines that the group understands the information when they pair which drug with the infection treated correctly? Select all that apply.

Erythromycin---acne vulgaris Ciclopirox---tinea pedis Acyclovir---episodes of HSV

Administration of estrogen is different in women who have an intact uterus or a hysterectomy. Which statement is correct?

Estrogen is administered alone after a hysterectomy.

A client is admitted to the health care facility with acute glaucoma. After administering the prescribed ophthalmic drugs, the nurse continues to assess the client for pain relief at which frequency?

Every 2 hours

A nurse is preparing to administer albumin intravenously to a client. The nurse anticipates noting which reason in the medical record of the client?

Experienced hypovolemic shock due to trauma.

A client is receiving a colony-stimulating factor and experiences dilutional anemia. The nurse would most likely determine which nursing diagnosis is most appropriate for this client?

Fatigue

A nurse determines a nursing diagnosis of Impaired Oral Mucous Membranes for a client receiving appropriate drug therapy for urge incontinence. The nurse would most likely choose this nursing diagnosis related to which drug?

Fesoterodine

A client with chronic open-angle glaucoma has been prescribed brimonidine tartrate. After administering the drug, the nurse should monitor the client for which potential adverse reaction?

Foreign body sensation

A client reports using ginger for motion sickness. The nurse would urge the client to use caution if the client has which medical condition?

Gallstones

A nurse is preparing to teach a caregiver of a client with AD about memantine. The nurse will explain that memantine exerts a change on which substance?

Glutamate

A health care provider has prescribed simethicone to a client with postoperative abdominal distention. Which assessment finding should the nurse prioritize in this client?

Heartburn

A nurse is preparing to administer iron dextran to a client. The nurse will obtain which information on the preadministration assessment to calculate the drug dosage?

Hemoglobin level

A child diagnosed with ADHD returns for a follow-up visit since starting lisdexamfetamine. The caregiver reports behavior has improved, the child is sleeping okay at night, and eats all the time. Assessment reveals the child has lost a few pounds since last visit and is in the lower percentile for their age. Which nursing diagnosis will be most appropriate for this client?

Imbalanced Nutrition: Less Than Body Requirements

A nurse is preparing to administer total parenteral nutrition to a client also receiving therapy for carcinoma. Which nursing diagnosis will the nurse prioritize for this client?

Imbalanced Nutrition: Less Than Body Requirements

The nurse is developing the plan of care for a client with a skin lesion requiring topical therapy. Which nursing diagnosis would the nurse most likely prioritize?

Impaired Skin Integrity

A nurse is preparing a teaching session for a client prescribed an anti-bacterial for a UTI. Which instruction should the nurse point out in the teaching session?

Increase fluid intake to at least 2000 mL/day.

A nurse is conducting the preadministration assessment on a client who is prescribed ferrous and notes the client is also currently prescribed ascorbic acid. Which potential reaction of these two drugs should the nurse prioritize for monitoring?

Increased absorption of iron

The nurse is preparing to administer ranitidine to a client who is currently receiving warfarin. Which assessment finding should the nurse prioritize for this client?

Increased bleeding

A nurse is teaching a client how to properly administer fosfomycin. The nurse determines the session is successful when the client correctly points out they will administer the drug in which manner?

Ingest the drug immediately after mixing with water.

A nurse is presenting information at a health fair concerning cancer. When questioned about the use of green tea, the nurse would point out which potential effect of green tea?

Insomnia

A nursing instructor is conducting a class discussion on the actions of vincristine. The instructor determines the class is successful when the students correctly choose which action?

Interfere with amino acid production in the S phase

A client with a nasogastric tube is prescribed misoprostol. The nurse anticipates administering this drug in which manner?

Liquid formulation

After teaching a group of nursing students about cholinesterase inhibitors, the instructor determines that additional teaching is needed when the students correctly choose which drug as an example?

Memantine

A client is brought to the emergency department for a drug overdose. The nurse concludes the emetic is safe to give to the client if which client assessment finding is noted?

Mental status is intact.

A nurse has administered ammonium chloride to a client as prescribed. Which assessment finding will the nurse prioritize?

Metabolic acidosis

After teaching a group of nursing students about upper gastrointestinal system drugs, the instructor determines that the teaching was successful when the students correctly choose which drug as a gastrointestinal stimulant?

Metoclopramide

An older adult client, who is hospitalized, develops a UTI and is prescribed appropriate anti-infective therapy. Which action should the nurse prioritize on the ongoing assessment for this client?

Monitor the client's vital signs every 4 hours.

A nursing instructor is teaching a group of nursing students about topical drugs for skin disorders. The instructor determines that the teaching was successful when the students correctly choose which drug is used to prevent institutional outbreaks of methicillin-resistant Staphylococcus aureus (MRSA)?

Mupirocin

A nurse is preparing to administer an ointment to two clients, one with a Staphylococcus aureus infection and another with a Streptococcus pyogenes infection. Which drug would the nurse predict the primary health care provider to prescribe? Select all that apply.

Mupirocin Retapamulin

A client with narcolepsy has been administered modafinil. Which reaction would the nurse prioritize for intervention?

Nausea

A nursing instructor is teaching a session illustrating the various forms of immunity utilized by the human body. The instructor determines the session is successful when the students correctly choose which type of immunity as developing after the use of ready-made antibodies from animals?

Passive immunity

A client is diagnosed with springtime allergic conjunctivitis. The nurse predicts the client will be prescribed which otic solution?

Pemirolast

A client with megaloblastic anemia is prescribed leucovorin. The nurse would question administration of this drug if which additional disorder is noted in the client's medical record?

Pernicious anemia

The nurse is preparing to administer donepezil to a female client. The nurse should question this order if which factor is noted in the client's record?

Positive pregnancy test

A client comes to the clinic after using azelaic acid and reports various concerns. The nurse suspects the client is experiencing a hypersensitivity reaction based on which signs? Select all that apply.

Pruritus Urticaria Erythema

The nurse is preparing to administer vitamin B12 to a client. The nurse would administer the drug cautiously if the client had which condition noted in the medical record?

Pulmonary disease

A nurse is preparing to administer IV fat emulsions to a client. The nurse will exercise caution when administering this solution after discovering the client also has which disorder noted in the medical record?

Pulmonary disorder.

A client is prescribed cyanocobalamin following gastric bypass surgery. The nurse will prioritize which finding on the ongoing assessment?

Pulmonary edema

A forest ranger arrives at a community clinic for prophylactic vaccination. The nurse predicts the health care provider will prescribe which vaccine for this client?

Rabies vaccine

A nurse is preparing a teaching session for a client with narcolepsy. Which instruction should the nurse prioritize if teaching about modafinil?

Record number of periods of sleepiness.

A nurse is preparing to administer polycarbophil to a client with irritable bowel syndrome. The nurse determines caution is warranted after discovering the history of which disorder in the client's history?

Rectal bleeding

A client has been prescribed a transdermal patch of estrogen. Which adverse effect should be included in the teaching plan about the medication?

Redness at the application site

The nurse is preparing discharge teaching for a client with anemia who is prescribed epoetin alfa for the next week. Which instructor should the nurse prioritize to the client?

Report signs of joint pain to the primary health care provider.

The caregivers of a child who is recovering from chickenpox tell the nurse the child was given aspirin for a fever. The nurse would prioritize the assessment for indications of which adverse reaction?

Reye syndrome

A client who is right-handed is to receive a booster injection for a previous vaccination. The nurse prepares to administer the injection at which site?

Right arm

A nurse in a health care facility is caring for a client who is receiving an antiemetic to control vomiting related to chemotherapy. Which nursing diagnoses should the nurse prioritize for this client's care plan?

Risk for Imbalanced Fluid Volume

A client is beginning therapy with terazosin. Based on the action of this drug, which nursing diagnosis should the nurse prioritize?

Risk for Injury

A client receiving ophthalmic drugs reports blurred vision. The client tells the nurse, "I almost fell yesterday." The nurse will prioritize which nursing diagnosis for this client?

Risk for Injury

The caregiver of a client with AD who is receiving cholinesterase inhibitor therapy reports several falls with more apparent clumsiness; up at night multiple times; a fair appetite and compliance with medication regimen. When developing the care plan, which nursing diagnosis should the nurse prioritize?

Risk for Injury

A nurse is caring for a client who is prescribed omeprazole and a benzodiazepine. Which assessment finding should the nurse prioritize?

Risk for toxic level of benzodiazepines

A group of nursing students are preparing a presentation depicting the cell cycles and the antineoplastic agents which work best at each phase. The instructor determines the students have correctly illustrated the information by including antimetabolites at which phase?

S phase

A client diagnosed with ulcerative colitis has been prescribed sulfasalazine. The nurse should prioritize which finding on the ongoing assessment?

Severe blood- and mucus-filled diarrhea

A nurse is preparing to administer potassium to a client. Which reaction should the nurse carefully monitor the client for if the use of salt substitutes is documented in the client's record?

Severe hyperkalemia

After teaching a group of nursing students about CNS stimulants, the instructor determines that the teaching was successful when the students correctly choose which factor as a contraindication?

Severe hypertension

The nurse is preparing to administer a topical medication to a client with a skin disorder. Which assessments should the nurse prioritize on the assessment? Select all that apply

Size of the area affected Appearance of the lesions Report of pain or burning

The nurse is monitoring a client who is receiving caffeine. The nurse determines the client is experiencing a therapeutic response with which assessment finding?

Skeletal muscle stimulation

A nurse has administered topical benzocaine to a client in preparation for a minor treatment. The nurse will prioritize which findings if noted on the ongoing assessment?

Stinging, tenderness, and sloughing

A nurse has administered amoxicillin to a client for a UTI. The nurse will prioritize which assessment finding on the ongoing assessment?

Stomatitis

A nurse is monitoring a client who is receiving IV electrolytes. Which priority action should the nurse take if the following are noted on the assessment of the intravenous site: redness, edema, warmth, and pain?

Stop the current infusion and restart the infusion in another vein.

A nurse is teaching a client about the antineoplastic agent which has been prescribed. When asked about potential hair loss, which answer should the nurse prioritize?

Suggest the use of a wig or cap

A nurse caring for a client taking warfarin develops a UTI. The nurse should monitor the client for increased risk of bleeding if which anti-infective is prescribed?

Sulfamethoxazole

A nurse is preparing to administer sulfasalazine to a client with inflammatory bowel disease. The nurse should question this order if the client's record indicates a hypersensitivity to which drug?

Sulfamethoxazole/trimethoprim

A client comes to the emergency department and reports extreme pain. Physical assessment reveals an erection. When obtaining the client's medication history, which drug would the nurse expect the client to report using?

Tadalafil

A nurse is preparing a teaching plan for a client with an acute peptic ulcer who is prescribed aluminum carbonate gel. Which instructions should the nurse prioritize for this client?

Take the drug hourly for the first 2 weeks.

The nurse is scheduled to administer sucralfate 1 gram po four times daily to a pregnant client admitted with gastroesophageal reflux disease (GERD). What is the priority teaching that would be provided regarding this medication?

Take the medicine one hour before meals and at bedtime.

The nursing instructor has completed a class discussion on the stages of AD. The instructor determines the class is successful when the students correctly choose which factor as characteristic of preclinical AD?

There are no cognitive changes noted.

When educating a group of nursing students on immunologic agents, the nurse refers to a substance that is attenuated (or weakened) but still capable of stimulating the formation of antitoxins. The nurse determines that the teaching was successful when the students correctly point out this agent as which substance?

Toxoids

The nurse is conducting an ongoing assessment on a client who has received doxapram. Which assessment should the nurse prioritize?

Urinary pattern

A 30-year-old female client is prescribed misoprostol. Which instruction should the nurse prioritize in the teaching session for this client?

Use a reliable contraceptive method.

A nurse is caring for a client during antineoplastic drug therapy and determines a nursing diagnosis of Impaired Tissue Integrity is appropriate. Which action would be appropriate for the nurse to suggest during the teaching session?

Wear loose protective clothing.

A client who is obese is to start receiving amphetamine as part of the treatment. Which factor should the nurse prioritize in the preadministration assessment?

Weight

The nurse is preparing a teaching plan for a 10-year-old client with ADHD and the caregiver's about the prescribed lisdexamfetamine. The nurse will point out which information will be important to record and report to the health care providers on routine visits?

Weight and growth

A nurse is monitoring a client prescribed dextran IV. Which finding on the ongoing assessment will the nurse prioritize?

Wheezing

A nurse is caring for a client who is prescribed 1% hydrocortisone/4.71 mg neomycin for bacterial infection of the external auditory canal. Which instructions should the nurse utilize when administering the otic solution?

With the client upright, remove the solution running out of the ear with gauze.

A nurse has administered nitrofurantoin to a client who is now reporting dyspnea, chest pain, and is coughing. Which action should the nurse prioritize?

Withhold the drug and contact the primary health care provider.

A nurse is caring for a female client who states she has a 28-day cycle. Which two hormones are influential in the female fertility cycle?

estrogen and progesterone

During a routine clinic visit, a client reports using an over-the-counter antidiarrheal agent for treatment of diarrhea. The nurse reviews the drug information with the client and determines the client grasps the importance of contacting the primary health care provider if the diarrhea is not resolved within which time frame?

48 hours

A client is prescribed two ophthalmic drugs that are to be administered at about the same time each day. The nurse instructs the client to separate the drug administration by which amount of time?

5 to 10 minutes

A nurse administers iron dextran 0.5 mL IM. The nurse would wait at least how long before administering the remainder of the dose?

60 min

A nurse is teaching a client how to properly apply a topical corticosteroid. The nurse determines the session is successful when the client correctly applies the medication in which manner?

Apply the topical corticosteroid sparingly.

A school nurse is explaining the various uses of a topical germicide to a group of high school students. The nurse determines the session is successful when the students correctly point out which uses? Select all that apply.

As a surgical scrub As a preoperative skin cleanser For washing the hands before and after caring for others On minor cuts and abrasions to prevent infection

A nurse is preparing a teaching session for a client prescribed methenamine for chronic bacterial UTIs. The nurse determines the session is successful when the client correctly points out which fact?

Avoid an excessive intake of citrus fruits.

A health care provider has prescribed bisacodyl to a client with constipation. The client reports epigastric pain and a burning sensation after taking the drug. Which instructions should the nurse provide to the client?

Avoid milk before taking the drug.

A nurse has administered trimethobenzamide to a client reporting nausea and vomiting. Which adverse reaction should the nurse prioritize on ongoing assessment?

Blurred vision

A nurse is preparing to perform a preadministration assessment on a client who is to receive donepezil for AD. The nurse will include which elements in this assessment?

Body weight

A nurse is preparing to administer goserelin to a client with prostate cancer. Which assessment findings should the nurse prioritize on the ongoing assessment?

Breast atrophy, sexual dysfunction

After teaching a group of nursing students about various ophthalmic drugs, the instructor determines that the teaching was successful when the students correctly choose which drug as a carbonic anhydrase inhibitor?

Brinzolamide

A nurse has administered cascara sagrada to a client with constipation. Which effects should the nurse prioritize in the client after administration of the drug?

Brownish discoloration of urine

A client, diagnosed with cancer, is prescribed an antineoplastic drug. Which factor should the nurse include in the discussion about the prescribed therapy?

Delays spread of cancer to other sites

A nurse is preparing to administer loperamide to a client with pseudomembranous colitis. Which findings on assessment would the nurse document as an indication of effectiveness?

Diarrhea is resolved.

The nurse is preparing to administer donepezil to a client with dementia. The nurse will monitor the client for which finding after noting the client is taking celecoxib for a history of arthritis?

Increased risk of GI bleeding

A nurse is preparing to administer bicarbonate to a client who is also prescribed fluoroquinolones. Which potential situation will the nurse carefully monitor the client for after administering these two drugs?

Increased risk of crystalluria

The nurse determines a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements is the priority for a client receiving antineoplastic therapy. Which suggestion would be least appropriate for the nurse to include in the client's plan of care?

Offer fatty foods to stimulate the taste buds

A client with a UTI is experiencing dysuria. The nurse would expect which drug to be prescribed?

Phenazopyridine

A health care provider has prescribed difenoxin with atropine to a client with acute diarrhea. The nurse will carefully monitor the client for which adverse reaction after noting the client is also prescribed a MAOI?

Increased risk of hypertensive crisis

The caregiver of a client diagnosed with AD asks the nurse about the prescribed therapy with rivastigmine and about how the drug works. The nurse would integrate knowledge of which action in the response to the caregiver?

Increases the level of acetylcholine in the CNS

A client with benign prostatic hypertrophy is questioning the nurse about saw palmetto. Which is the best response from the nurse related to the use of this herb?

Need to be reevaluated after 6 months of use.

A nurse is caring for a client with hypertension and anemia. Which action would the nurse include in the plan of care when administering epoetin alfa to the client?

Note the hematocrit value before each dose during therapy.

A nurse is preparing to initiate IV access for a client. After selecting the site, which step would the nurse do next?

Place a tourniquet above the selected site.

A nurse has administered estrogen and phenytoin to a client. Which reaction should the nurse plan to monitor the client carefully for?

Possibility of breakthrough bleeding

A client who is prescribed digoxin is receiving electrolyte replacement therapy. The nurse would monitor the client for signs of digoxin toxicity if which electrolyte is administered?

Potassium

A nurse is assessing a client receiving IV fluid and electrolyte therapy. Which laboratory test result will the nurse prioritize?

Potassium 2.1 mEq/L

A client, who is prescribed vinblastine, is also currently administered warfarin. The nurse will carefully monitor the client for which reaction?

Prolonged bleeding

A nurse is preparing to administer methenamine to a client for UTI. The nurse will question this order if the client is noted to be allergic to which substance?

Tartrazine