" is talking about a period of time stretching up until the present. " is talking about a period of time stretching up until some point in the past. So, the sentence that you quote could be part of a past-tense narrative, used at a moment when the point of narration is just beyond the start of the exam.
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nkspb"Not a word had she written since the exam had started."It is a subject-verb inversion rule applied when the sentence begins with a negative adverb. The subject and verb are interchanged. The normal order is:
nkspbNot a word had she written since the exam had started.= She had not written a word since the exam (had) started.