Quiz question update issues
You are dealing with a caching issue. I just added the quiz module to a fresh install of Drupal 7.28, made a quiz with one question with three choices, and when I viewed it there were three options. So far so good. Then, I went back and added two options to that question, but when I viewed it I didn't see the two new options show up. 

All I had to do was take one version of the quiz and the next time I loaded the quiz the new options showed up. I suspect each user gets a cached version of the quiz when they start taking it, which would make sense in that you don't want to have a different/changed quiz for someone who is halfway through taking one. 

I haven't used the quiz module at all, but it looks like it has steady, active development, which is good. You could look into Drupal Webform module as an alternative or search for Drupal Learning Management Systems, if an LMS is really what you are building.