Integrated Project Planning and Design is a prerequisite for healthcare facilities under LEED v4. The intent is to maximize opportunities for the adoption of cost-effective integrated green design and construction strategies as early as pre-design1.
Reference:
LEED v4 | HPAC Engineering1

Explanation
LEED certification is a process that evaluates the environmental performance and sustainability of a building project based on a set of rating systems. To earn LEED certification, a project must satisfy all the mandatory requirements, or prerequisites, of the chosen rating system, and earn a minimum number of points by meeting optional criteria, or credits. The number of points determines the level of certification: Certified (40-49 points), Silver (50-59 points), Gold (60-79 points), or Platinum (80+ points)123.
Employing a LEED AP (Accredited Professional) on the project team is not a requirement for LEED certification, but it can provide an advantage, as LEED APs have demonstrated their knowledge and expertise in green building and LEED rating systems. Having a LEED AP on the project team can also earn one point under the Integrative Process credit4.
Conducting a whole-building life-cycle assessment is not a requirement for LEED certification, but it can be an option for earning points under the Building Life-Cycle Impact Reduction credit. A life-cycle assessment is a method of evaluating the environmental impacts of a building over its entire life span, from extraction of materials to disposal or reuse3.
Earning a minimum of 50 points or meeting a prerequisite is not a sufficient condition for LEED certification, as it does not account for the other prerequisites or the level of certification. A project must meet all the prerequisites and earn at least 40 points to qualify for the lowest level of certification

Explanation
The Energy and Atmosphere Credit in LEED encompasses building loads, energy performance management, and environmental quality (EQ). Building loads refer to the amount of energy consumed by a building's systems, such as heating, cooling, lighting, and equipment. Energy performance management involves strategies to reduce energy consumption and improve efficiency. Environmental quality refers to the conditions inside the building, including air quality, thermal comfort, and access to daylight and views. References: LEED Green Associate Candidate Handbook, U.S. Green Building Council resources

Explanation
A 100% vegetated roof coverage best addresses both heat island effect and rainwater runoff from the roof only. A vegetated roof, also known as a green roof, is a layer of living plants that covers the roof surface. A vegetated roof reduces the heat island effect by providing shade, evapotranspiration, and insulation, lowering the roof temperature and the surrounding air temperature. A vegetated roof also reduces rainwater runoff by retaining and absorbing precipitation, decreasing the volume and peak flow of stormwater leaving the roof.
The other options are not as effective as a 100% vegetated roof coverage in addressing both heat island effect and rainwater runoff from the roof only. A 100% high-albedo roof reflects more solar radiation than a conventional roof, reducing the heat island effect, but it does not reduce rainwater runoff. A 20% high-albedo and 80% conventional roof has a lower reflectance than a 100% high-albedo roof, resulting in a higher heat island effect, and it does not reduce rainwater runoff either. A 50% standing seam copper and 50% vegetated roof has a lower vegetated area than a 100% vegetated roof, resulting in less shade, evapotranspiration, insulation, retention, and absorption, leading to a higher heat island effect and more rainwater runoff. References: LEED Green Associate Candidate Handbook, page 27; USGBC, [Sustainable Sites], page
3.

Explanation
The Montreal Protocol is an international treaty that aims to protect the ozone layer by phasing out the production and consumption of ozone-depleting substances (ODS). ODS are chemicals that contain chlorine or bromine, which can destroy the ozone molecules in the stratosphere. CFCs, or chlorofluorocarbons, are a group of ODS that were widely used in refrigeration, air conditioning, aerosols, and solvents. The Montreal Protocol banned the production of CFCs in 201012. Freon is a trade name for some CFCs and HCFCs, or hydrochlorofluorocarbons, which are also ODS but less harmful than CFCs. The Montreal Protocol also controls the production of HCFCs, which are being phased out gradually12. Ammonia is not an ODS and is not regulated by the Montreal Protocol1.
References:
The Montreal Protocol on Substances That Deplete the Ozone Layer | U.S. Department of State2 Montreal Protocol - Wikipedia1 The Montreal Protocol: fixing the ozone layer and taking climate action - Canada.ca3