I have been playing with various layouts, the following show what these new layouts will look like, lots of options will come in future versions though.
Including images in quizzes - Example 1 *Single image usage*:


The above shows an example of using a single image in a quiz question, on the left shows the layout when the question is first accessed and on the right shows the layout when the image is zoomed, to zoom in on an image the user just has to tap it and then tap it again to return.
Including images in quizzes - Example 1 *Multiple image usage*


The above show four images used, and can be viewed in a similar manor to example 1.
The changes have been submitted to Apple today and will be available as a free update the in a week or two.
It has been quite a job to design and add this to the system but believe it is well worth the effort, I look forward to everyones comments so please let me know your thoughts and suggestions.