A multiple-choice exam was a type of exam where the examinee was given several possible answers from which to choose the correct one.
In 2293, after being incarcerated at Rura Penthe, James T. Kirk asked a complaining Leonard McCoy if he was afraid of the future. When McCoy confirmed he was, Kirk told McCoy that he didn't meanthis future, i.e. spending the rest of their lives imprisoned there. Upon McCoy's question, "What is this? Multiple choice?", Kirk explained he was referring to a future without the Neutral Zone. (Star Trek VI: The Undiscovered Country)