const str = "  Hello, World!  ";

const result = str
  .trim()
  .split(", ")
  .map((word, i) => {
    return i === 0
      ? word.toUpperCase()
      : word.replace(/!$/, "").split("").reverse().join("") + "?";
  })
  .join(" | ");

const [first, ...rest] = result.split(" | ");
const final = `${first} | ${rest.join(" & ")}`;

console.log(final);