Step 1: First we have to write polynomials in descending order.
$$ \begin{aligned} P(x) &= -16x+3 \\ Q(x) &= 5x-8 \\ \end{aligned} $$Step 2: Write second polynomial below the first one. Making sure like terms are lined up.
$$ \begin{array}{lrr} & -16x & 3 \\ \color{blue}{ + } & 5x & -8 \\ \hline \end{array} $$Step 3: Combine like terms (add each column):
$$ \begin{array}{lrr} & -16x & 3 \\ \color{blue}{ + } & 5x & -8 \\ \hline & -11x & -5 \end{array} $$