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Quizzes in Moodle are nice for assessment as they are self-grading and provide students with an instant score. They create challenges because students will use books and materials to take the exams, they may take them collaboratively, and if the course is using publisher materials (for example a question bank provided by the textbook publisher) then students may be finding those answers on the broader internet.
High stakes exams can use remote proctoring services. Please contact the CTL instructional designers for more details.
The most difficult to cheat assessments are large-scale, scaffolded projects that are due in pieces across several weeks. These can be more work to grade but are more academically honest. Ultimately the assessment method should match the nature of the course and the discipline.