You have to read line by line from the beginning of the file, until you reach the line you want.
It would be more efficient (if there aren't too many lines) to read all the lines at once in memory (e.g. in a List<string>) and get the lines from there:
List<string> allQuestions = File.ReadAllLines(fileName).ToList();
For example, to get a random question:
string question = allQuestions[r.Next(allQuestions.Count - 1)];
(F-ES Sitecore told you here about the random numbers.)
The next (easy) step would be to include the answers as well...