The output of Get Axis is a float from -1 to 1. The multiplier lets you multiply the output so the range is bigger (multiplier of 40 results in a range from -40 to 40). For example, if you're using the output to move a character, the multiplier might be the maximum speed the character can move.
To interpret axis movements as buttons use the Axis Event action. It sends events based on the horizontal and vertical axis. You could use this to send Up, Down, Left, Right events.