@jhileman, can you pull a couple of shots of your Inkscape settings?
- First what version of the program are you running? (Check at Help > About Inkscape).
- Next…I’d be interested in seeing a screenshot of your Bitmap Preferences settings…
Go to Edit > Preferences > Input/Output > Bitmaps and take a screen shot of the settings.
If they are different from the settings showing below, you can try these and see if things start sizing correctly for you. If that doesn’t work, you can set them back to what you had from the Screen shot.