Your menuexec line needs a leading semicolon:

;@MENUEXEC emptriv exec /drive0/files/emptriv/emptriv

It needs to be located in the [hijack] section of config.ini, which you should add if it doesn't exist.

Question files are as you described. You should indeed be able to export a tab-separated file with those fields in it, but I've not tried it myself. The questions that come with the program were generated with a bunch of Perl scripts.

All of that being said, emptriv was indeed written a long time ago and I can't guarantee it still works properly. I still have it on my own player, but haven't fired it up in ages.