At the beginning of your upkeep, exile the top card of your library. You may play that card this turn. At the beginning of your end step, if you didn't play a card from exile this turn, create a tapped Powerstone token.
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Although all the cards in The Brothers' War that create Powerstone tokens create a tapped Powerstone token, entering the battlefield tapped isn't part of the token's definition. Notably, if you create a token that is a copy of a Powerstone token, the token copy won't enter the battlefield tapped.
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If the card you exiled with the first ability is an instant, you may play it during your end step after Visions of Phyrexia's last ability has already resolved and created a Powerstone token. We call this having your cake and compleating it too.
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If you played a card from exile for any reason, the ability won't trigger, even if it wasn't the card you exiled with the first ability.
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Powerstone tokens are a kind of predefined token. Each one has the artifact subtype "Powerstone" and the ability "{T}: Add {C}. This mana can't be spent to cast a nonartifact spell."
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You can use the {C} added by a Powerstone token on anything that isn't a nonartifact spell. This includes paying costs to activate abilities of both artifact and nonartifact permanents, paying ward costs, and so on.
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You must follow all normal timing rules for a card you play using Visions of Phyrexia's first ability and, if it's a spell, you must pay its costs to cast it.