Each exam differs in its content. Some are simply 50 multiple choice questions; some have simulations where you have to carry out specific tasks like enabling fine grained passwords, or setting up DNS scavenging; and some have 'testlets' where you are presented with a scenario containing a lot of information on a company's server and network infrastructure, then get asked 5-10 multiple choice questions on the scenario, such as what method would you use to deploy a new application, or how you would improve logon times in a certain country.