A good multiple choice question tests whether a student understands the material, not whether they can read a tricky sentence. Three things separate strong items from weak ones.
A clear stem. The question should pose one complete problem before the student even looks at the options. If a reader cannot tell what is being asked without the answer choices, the stem needs work.
One defensible correct answer. Exactly one option should be right, and an expert should agree it is right. Best-answer questions are the exception, where several options have merit and one is clearly strongest.
Plausible distractors. The wrong options should tempt a student who only partly understands. The most effective distractors come from the actual mistakes and misconceptions learners make, which is exactly what the AI draws on when it generates them. Keep every option similar in length and grammar so the wording never gives the answer away.
How many options? Research settles a long debate here: a meta-analysis covering roughly 80 years of studies found that three options (one correct answer and two distractors) assess learning as reliably as four or five, because writing a genuinely plausible fourth or fifth distractor is hard and weak ones rarely fool anyone. Most instructors still write four, and PDFQuiz lets you set the count and edit the choices. Avoid "all of the above," "none of the above," and joke options, which test reading and guessing more than knowledge.