Okay, that's pretty straightforward but will require some work. You'll need:
TABLES
(The exam table isn't strictly necessary, but will allow you to store multiple exams in one database)
tblExams
ExamID
ExamName
ExamClass
(and any other information that is unique to each EXAM, like chapter, week of class, etc)
tblQuestions
QuestionID
ExamID (Use this to link back to tblExams)
QuestionText
ImgPath
AnswerMethod (1 = Pick one, 2 = Pick many, 3 = Essay)
(any other question-specific data you wish to include)
tblAnswers
AnswerID
QuestionID (Use this to link back to tblQuestions)
AnswerText
IsCorrectAnswer
(any other answer-specific data you wish to include)
(Essay questions would just need a dummy answer)
tblStudents
StudentID
StudentFN
StudentLN
(Any other necessary data)
tblResults
QuestionID
StudentID
AnswerID
AnswerText (for essay questions)
Then create a main form. In the detail section, you'd have the question number and text as well as an image frame using the image path as a source. Below that, create a subform frame. You'll need three subforms - one with an option group, one with checkboxes, and one with a memo field. You'll use code to assign the correct form to the subform frame based on AnswerMethod. The subform answers would be pulled from the Answers table, linking via ExamID and QuestionID. The option buttons, check boxes, and Essay text box would, however, actually have to be unbound and would create matching records in the Results table.
I'm sure there's more involved, but this should get you started. You have a lot of work ahead of you, I'm afraid, but it's a LOT less than creating 200 different forms (especially as you'd still need most of these tables).