To add radicals, they must have the same radicand (expression under the radical). Let's try to simplify each radicand:
-5√48 + 4√108
= -5√(16*3) + 4√(36*3)
= -5√(42*3) + 4√(62*3)
Now √42 = 4 and √62 = 6 so we can take those outside of the radical:
= -5*4√3 + 4*6√3
= -20√3 + 24√3
= 4√3