Imagine for a minute that there is a composer named John Cage, and he likes to compose abstract music. For instance, he composes a piece entitled 4'33" (four minutes 33 seconds), which is just that length of time—silent—as a pianist sits on a piano bench before leaving the stage.
How would one punctuate the name of the song? I did nothing in the example because I think it looks weird to have two sets of end quotation marks, but I technically shouldn't italicize it. Is "4'33"" really right?