I know this is probably a noob problem to many, but since I came across it, I thought I'd mention it.

When adding in photos to a Picture Trivia Game, make sure you adjust the stage of the .swf image you've created so that it fits in with the rest of the game.

For CS4:
Right-click on a blank part of the stage
Click "Document Properties"
Change dimensions (Gary's are 200w and 80h)

Now, assuming you've imported your image to the stage and it's the right size (Gary suggests 200x80), everything should line up just fine.

Hope this helps someone!