I don’t tend to use #1 as I suspect that heuristic isn’t (usually) true, although it depends on the test writer. A multiple choice test with 4 answers for each question and randomly distributed answers only has a 25% chance of the same answer twice in a row and a 6.25% chance of three in a row. This can lead you to see a pattern that isn’t there. Granted, if you have no idea what the answer is, it’s reasonable to fall back on #1 and not pick the same answer as the previous. But if you have any inkinling that an answer is more likely to be correct, I’d pick that one regardless of whether the prior or next answer was in the same position.

My general process is elimination. Look at the answers and eliminate the ones you know are not correct. Then tentatively eliminate the ones you suspect are wrong. Now you have a remaining set of possible answers. Of course, if there is only one, pick that. if the remaining answers seem they could be true, pick all of the above or “X and Y” as appropriate unless the answers are contradictory. If there is contradiction, use your best guess to pick a non-contradictory answer.

That’s about it for my process.

To clarify, I am not advocating that the above points are applicable in every case. These are ultimately observations just like weather forecasts and one must exercise their own common sense to determine if it is even worth approximating the correct option like this. What I tried to accomplish here was just a thought experiment and maybe a way to guide someone to the correct solution if a question did not make sense to them at all.