You pass, that's what happens.
Background: 6 months ago I took the 299 & 298 back to back. Passed 299 and failed 298. Never studied for the new testlet format. Almost passed but it still sucked to have my first fail on my last exam.
Fast forward to two days ago. Going through my old email I find a retake voucher that I forgot I had and had to be used by end of the month. How can you forget finishing your MCSE? In simplest terms, life. So I find a place that isn't booked that is about 60 miles away and book the exam.
So I haven't studied for 6 months and had to drive 60 miles to face the only test that I have failed and am nervous about. Sounds like fun huh? Well I spent maybe 3 hours the day before reviewing notes and taking the Microsoft practice tests and the Transcender demo. I focused not on the material, which I surprisingly remembered almost all of, but on the format of the test. That's how I was able to take the Transcender demo test 10 times. That's right, one test taken 10 times! LOL.
Anywho. Found a nice testing center and was finally able to pass. MCSE:S 2003 baby!

Most questions tell you where to look. Say, how would you design this as per what the CIO wants? So you flip to the CIO's statement and realize what needs done. Some questions say what is the best way to secure something? In reality you really don't need to flip back to the case study. You can eliminate two answers and focus on what Microsoft is really trying to teach for this exam. Wouldn't say it was easy, but pace yourself. Don't rush, they give you time to read the question and to skim through the case study to find the answer.
What must be 7 years and 10 tests later (A+, Net+, Sec+, 270, 290, 291, 293, 294, 299, 298 ), I'm finally MCSE:S. I did it on my own time and I actually learned the material. Good luck to all.