Large language models can produce confident but protocol-invalid answers in domains where procedural compliance is critical. This paper presents Answer Engineering, a deterministic runtime and authoring layer that applies localized rule-guided interventions to the visible reasoning trajectory during standard autoregressive generation, without retraining, modifying model weights, or performing global search. The method is evaluated on a controlled clinical benchmark for sudden sensorineural hearing loss (SSNHL), where correct management depends on protocol-consistent interpretation of symptom timing, Weber/Rinne tuning-fork findings, and otoscopic findings. In the benchmark, step-by-step reasoning shifted rather than eliminated errors: compliant outcomes for SSNHL decreased from 54.5% under unguided generation to 25.1%, while acceptance on the conductive contrast condition increased from 1.6% to 58.9%. Local trajectory editing increased SSNHL compliance to 83.5% and conductive-case adherence to 77.9%, raising balanced accuracy from 42.0% under reasoning-only generation to 80.7%. The results support a systems-level view in which protocol adherence can be improved through auditable runtime control of reasoning trajectories, while also identifying limitations caused by rule coverage, trigger reliability, and persistent diagnosis-first generation dynamics.

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