Of course I can't say anything about the exam itself other than what's publicly available, but I can at least talk about my experience.
I tried to remove as much uncertainty as possible by actually driving to the test center at the time of day on the day of the week I was scheduled to take the exam (just 2 weeks earlier). That helped me figure out how much driving time I needed, what parking was like, what traffic was like, etc. And when I was there I went into the building and found both the test center and the bathrooms (you never know whether you're going to have to run out quickly from a 4 hour exam). I even opened the door and saw the waiting room - which was freezing. So I planned clothing accordingly.
All that paid off in getting me in and settled. Phone off, everything in a locker although the center had people leave out food, water, medications - anything they'd come out of the test room to consume.
There were a lot of different tests going on, everything from the PMP I was taking to a CPA exam. Some of the exams were in parts and people could leave between the parts, some wouldn't allow people to leave the test room. The process for getting into the room was the same - turn pockets out, take glasses off for examination, sign in literally, and head into the room to an assigned room.
I'd taken sample tests so I'd understand the basics of the software, so that helped. The software had a calculator and I was given scratch paper and two pencils with instructions for getting more if I needed it. One thing that the test center software had that the practice exams did not was the ability to cross out as many of the answers to a question as you wanted. That information didn't go anywhere, it was just for the convenience of the test-taker, but it made it a lot easier for me to review the questions I'd marked on the way through.
About halfway through I was sure there was no way I was going to pass. But…pass I did. The computer scored the test immediately. There's no indication of how many were correct, but there was some tiered information that helped me see generally how I did in the various categories. When I left - signed out, etc. - I was given a printout of that information.
I can't imagine I'll ever fall behind on PDUs, the test is as hard as the prep courses tell you it is. Whew! I got a congratulatory email from PMI the next day with a link to my test results and the status was already reflected on my profile. A lovely certificate arrived in the mail about 2 weeks later.